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SAN J O A Q U I N Environmental Health Department <br /> COUNTY <br /> Crcatncs5 tgrov,' her , <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 bottom 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 corrections <br /> Operator's certification <br /> Inspection Date . April 15 , 2019 Inspected By : JOHN ALANIZ <br /> Facility Address , 760 INDUSTRIAL DR , STOCKTON CERS ID : 10182411 <br /> certify under penalty of law that : <br /> 1 . I 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 /> / / <br /> V Photos ✓ Paperwork V 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 and/or <br /> imprisonment for known violations . ( HSC 25191 ) <br /> Name : J0,1 (Pk Y? i0 ^ n � C�lzanr� Y�„ jitle : <br /> Signature : Date : C7 _ <br /> 41 <br /> �y <br /> • l . �) Plt 4 . 1j <br /> rk"✓ 110NMENTAL HFAI. T} ! <br /> _S <br /> 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468-3420 1 F 209 464 -0138 1 www. sjcehd . coni <br />