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AUG-21-2008 02:03 FROM:SCKAASF 209-983-53.94 70:2094683433 PAGE:02 <br /> SAN JOAQUI14 COUNTY <br /> ENVIRONMtNTAL HEALT.WbJEPARTMENT <br /> 600 East Main Street,Stockton,CA 95202-3029 <br /> Telephone.-(209)468-3420 Far.-(209)469-3433 Web.-�j <br /> .�jj y.or /ehd <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> AnyI AftNOR violations noted in the"Notic6 to Comply"in the attached inspection report must be <br /> corrected within 30 4ns of receipt of this inspection. This certification form must be submitted to the <br /> Environmental Health Department (EHD) Address at the top of this form within 35 days 01'-receipt of the <br /> inspection report. <br /> All corrections to other violations noted in the attached Inspection Report(IR) or Continuation Form, or <br /> disputes to any violations, are to be submitted using this cerfification and returned to EHD within 60 days <br /> unless otherwise specified in the IR. <br /> For this certification to be co mdplete the operator of the site must include: <br /> 0 A statement documenting what corrective actions were taken or will be taken for each violation <br /> 0 Copies of sample results/manifests/tr'aining records/other appropriate paperwork, ,:and/or photos <br /> verifying corrections <br /> e Operator's certification <br /> Inspection Date: &_ 01PO7 Inspected By: pot".1kAoq A,91Q14. <br /> 1Y <br /> Facility Address EPA ID#: 0X1S-A2c91',06_2A <br /> I certify undei, penalty of law that: <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 cor:ipliance FOR <br /> EACH VIOLATION and I believe the information to be true,accurate, and complete: <br /> —Photos Y`O'Paperwork 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 <br /> possibility of fine and/or imprisonment for known violations. (HSC 25191) <br /> Name: 41V#Vfi9 At )44 Title:_8 V6&-n1 S(,0et,43a- <br /> Signature: Date: a2 <br /> EHE) 22-02-005 Rev 05/07 <br />