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PUBLI HEALTH SERVICES PpUlry <br /> SAN JOAQUIN COUNTY <br /> E YIRONMENTAL HEALTH DIVISION H :< <br /> Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer <br /> 304 E.Weber ve., 3rd Floor * P. O. Box 388 • Stockton, CA 95201-0388 �q ...•,,... :P <br /> 209/468-3420 <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> In the matter of th Violation(s) cited on 10 o27/q7 <br /> As Identified in the Inspection Report dated .27 <br /> Conducted by j'-(IKe qe Gl (agency or agencies) <br /> I certify under pen Ity of law that: <br /> 1. Responden has corrected the violations specified in the notice of violation cited <br /> above. <br /> 2. 1 have pers nally examined any documentation attached to the certification to <br /> establish th t the violations have been corrected. <br /> 3. Based on y examination of the attached documentation and inquiry of the <br /> individuals ho prepared or obtained it, I believe that the information is true, <br /> accurate, a d complete. <br /> 4. 1 am autho ized to file this certification on behalf of the Respondent. <br /> 5. 1 am awar that there are significant penalties for submitting false information, <br /> including th possibility of fine and imprisonment for knowing violations. <br /> Name (Print or T pe) Title <br /> NJ ( r---� - 1 <br /> 7 /17 <br /> Signature ; ate igned <br /> cAD � � 15 �r70�� <br /> Company Name EPA ID. Number <br /> A Division of San Joaquin County Health Care Services <br />