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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. sjgov . orrg/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 days 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 ( I R ) 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 05 , 2014: 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 Paperwork ✓ Statement <br /> 3 . l 4risonmen <br /> mit this certification on behalf of the Respondent. <br /> 4 . I re significant penalties for submitting false information , including the possibility of a fine <br /> anknown violations . ( HSC 25191 )NamV Title: 1 - �1 IN ofSignDate: ` � ^ <br /> -fTTi4o , i .i or <br /> Jimmy Mozinge <br />