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;AN JOAQUIN COUNTY UNI IEC IOGRAM AGENCY <br /> :NVIRONMENTAL HEALTH DIVISiuN <br /> ;04 E.WEBER AVENUE <br /> ;TOCKTON, CA 95202 <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> W <br /> For Hazardous Waste Generators <br /> In the matter of the Viol tion cited on: <br /> As Identified in the Insp ction Report dated <br /> Conducted by: [EHD Inspector(s)] <br /> I certify under penalty of law that: <br /> 1. Respondent has corrected the violations specified in the notice of violation cited <br /> above. <br /> 2. I have pe sonally examined any documentation attached to the certification to <br /> establis that the violations have been corrected. <br /> 3. Based o my examination of the attached documentation and inquiry of the <br /> individu Is who prepared or obtained it,I believe that the information is true, <br /> accurate and complete. <br /> 4. I am autt orized to file this certification on behalf of the Respondent. <br /> 5. I am aware that there are significant penalties for submitting false information, <br /> including,the possibility of fine and imprisonment for knowing violations. <br /> F/ hi 6 ro-12ormt\ <br /> Name(Print or T e) Title <br /> UV V <br /> Signature Date Agnedl <br /> o�ay3��3 �1 <br /> Company Nami EPA ID. Number <br /> DTSC-RETCOMP.CRT(8/99) <br />