Laserfiche WebLink
0 SAN JOAQUIN COUNTY 40 <br />ENvIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephom: (209) 468-3420 Fax. (209) 468-3433 Web: viww.sjgoy.org/ehd <br />I IZA DN •It 11 41 # I <br />Any MINOR violations noted in the "Notice to Comply" in the attached inspection report must be <br />corrected within 30 days of receipt of this inspection. This certification it must be submitted to the <br />inspection report. <br />All corrections to other violations noted in the attached Inspection Report (IR) or Continuation Form, o <br />disputes to any violations, are to be submitted using this certification and returned to EHD within 6701da <br />unless otherwise specified in the IR. <br />• A statement documenting what corrective actions were taken or will be taken for each violat'l <br />• Copies of sample results/manifests/training records/other appropriate paperwork, and/or phot <br />verifying corrections <br />ffm�8i : ,: <br />I 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 FOR <br />EACH VIOLATION and I believe the information to be true, accurate, and complete: <br />Paverwork Statemejj <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 <br />possibty of a fine and/or imprisonment for known violations. (HSC 25191) <br />10 <br />Im- <br />