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COMPLIANCE INFO_2020
EnvironmentalHealth
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2200 - Hazardous Waste Program
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PR0542618
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COMPLIANCE INFO_2020
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Last modified
8/4/2020 3:26:19 PM
Creation date
6/4/2020 12:10:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0542618
PE
2221
FACILITY_ID
FA0016720
FACILITY_NAME
ELI TAVAREZ
STREET_NUMBER
8151
Direction
E
STREET_NAME
PELTIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00705012
CURRENT_STATUS
01
SITE_LOCATION
8151 E PELTIER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\gmartinez
Tags
EHD - Public
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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, segov . 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 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 ( 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 /> March 08 , 2018 <br /> Inspection Date : Inspected By : Cesar Ruvalcaba <br /> Facility Address : 8151 E PELTIER RD CERS ID : 10185291 <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 . 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 possibility of a fine <br /> and/or imprisonment for known violations . ( HSC 25191 ) <br /> Name : Title: <br /> Signature : Date: <br />
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