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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone. (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd <br />1 1114 Do fill lj� 11 1 Oil! jii� 11 1,11 [4511"411,51 <br />ITIM11ro $17- • •'61IM4 0 F, IN. qla @4 FS <br />WAI"R W -mom <br />inspection report. <br />All corrections to other violations noted in the attached Inspection Report (IR) or Continuation Form, or <br />t* <br />unless otherwise specified in the IR. <br />For this certification to be completethe 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 <br />verifying corrections <br />• Operator's certification <br />11 mi•191r�. t % <br />Facility Address: EPA ID#: <br />1. 1 have corrected the violations specified in the Inspection Report from the above-mentioned <br />inspection date. <br />2. 1 have personally examined the following documentation submitted as proof of compliance FO <br />EACH VIOLATION and I believe the information to be true, accurate, and complete: i <br />.—Photos—Paperwork StatemeiM <br />sioRkilemirm droullIEW-1 $0 Flue I $oil) wim lot Note (00,40 RMINKTALIM! 1WESMIs <br />W�•��� <br />WIM <br />it <br />11 11' 1 11 <br />Title: <br />ME <br />