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10/01/2004 16:26 FAX <br />10/01/2004 12.44 FAX 916 2 703 OTSUOISS <br />va/et$/[aura 14,41 FNA <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />804 E. WEBER "ENUK <br />GTOCKTONj QA 96202 <br />REFor Hazardoua Waste Generators <br />OCT 0 1 Z004 <br />r <br />Identified In ths Inspectiondated: <br />1a001/001 <br />1@ 002 <br />402/00 <br />HD Inspeotorfell <br />1. Respondent has corrected the V19lations specified In the notice of <br />violation altud above. <br />2. 1 have personally examined any documentation attached to the <br />Certification to establish <br />BasedS. V.'.my examination r @#@-QjjqAdacumentatLon and <br />inquiry of the individuals who prepared or obtained It, I believe that <br />the Information Is true, acauratei and complete. <br />4. 1 am authorized to file this certification an behalf of the Respondent. <br />5. 1 am aware that there <br />_slanificent penaltiessubmitting false <br />infit = ♦ • i possibility •fine <br />and <br />Imprisonment <br />•_ o , <br />knowing ♦ • <br />_ a+ <br />Facility Address EPA ID. Number <br />P <br />Type)Name (Peint or <br />1 <br />9 - <br />Date Signed <br />2H0C1KKT 4rev 1J0?102' <br />