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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue , Stockton , California 95205-6232 <br /> Telephone: (209 ) 468-3420 Fax : (209) 468-3433 Web: www. sigov. org/ehd <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 da vs of <br /> receipt of this inspection . This certification form must be submitted to the Environmental Health Department (EHD) address <br /> at the top 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 days 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 <br /> billed 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 be taken for each violation <br /> Copies of sample results/manifests/training records/other appropriate paperwork, and/or photos verifying <br /> corrections <br /> Operator' s certification <br /> Inspection Date : May 26 , -2017 Inspected By : Elena Manzo <br /> Facility Address : 7611 S AIRPORT WAY CERS ID : 10181317 <br /> I certify under penalty of law that: <br /> 1 . 1 have corrected the violations specified in the Inspection Report from the above-mentioned inspection date . <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br /> and I believe the information to be true , accurate , and complete: <br /> Photos PaperworkStatement <br /> 3 . 1 am4authoizoit this certification on behalf of the Respondent. <br /> 4. 1 amre significant penalties for submitting false information , including the possibility of a fine <br /> and/ known violations . ( HSC 25t91 ) <br /> Name0 � Title: VY�SignatDate: <br /> Ao 1i?s74;;rw <br /> Jimmy Mozingo <br /> i <br />