Laserfiche WebLink
RECEIVED <br /> MAR 18 2070 <br /> Environmental),HoAkt4� N4,�1?, AWiq itr I <br /> SAN � JOAQUIN DEA) RTNICN "I <br /> COUNTY <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the " Notice to Comply' in the attached Inspection Report must be corrected within 30 days of <br /> receipt of this inspection . This certification form must be submitted to the Environmental Health Department ( EHD ) address at <br /> the bottom of this form within 30 days of receipt of the Inspection Report . HSC 25404 . 1 . 2 (c) ( 1 ) <br /> All corrections to other violations noted in the attached Inspection Report ( IR) or Continuation Form , or disputes to any <br /> violations , are to be submitted using this certification and returned to EHD within 30 dans unless otherwise specified in the <br /> Inspection Report . HSC 25185 (c) (3 ) <br /> Note : All EHD staff time associated with failing to comply by the above noted dates will be billed <br /> at the current hourly rate . <br /> For this certification to be complete , the operator of the site must include : <br /> A statement documenting what corrective actions were taken or will <br /> ltbepaperwork ,aknfeandach /orolation verifying corrections <br /> Copies of sample results/manifests/training records/other appropriate p <br /> Operator' s certification <br /> Inspection Date : March 06 , 2020 Inspected By : PAUL NSO <br /> Facility Address : 6649 EMBARCADERO DR , STOCKTON CERS ID : 10181463 <br /> I ME ME ME ME ME ME ME OEM MEN ME <br /> certify under penalty of law that: <br /> 1 . I have corrected the violations specified in the Inspection Report from the above- mentioned inspection date . <br /> 2 . I have personally examined tobefollowing <br /> documentation <br /> tion submitted as proof of compliance FOR EACH VIOLATION <br /> and I believe the informationf <br /> Photos Paperwork V Statement <br /> 3 . 1 am authorized to submit this certification on behalf of the Respondent . <br /> 4 . 1 am aware that there are significant penalties for submitting false information , including the possibility of a fine <br /> and/or imprisonment for known violations . ( HSC 25191 ) <br /> A <br /> Name : /' , j� f orN Title: 7 jo-J6 If ke r <br /> Date : <br /> Signature : <br />