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NOV-22-2004 10:10 AM THOMAS & DARLENE DAY <br />SAN JOAQUIN COUNTY UNIFIED PROGRAM AGENCY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />Soo E. WEBER AVENUE <br />STOCKTON, CA 95202 <br />209 726 5228 P.03 <br />V4 fo �-) <br />CERTIFICATION OF RETURN To bomPLIANCE H <br />• Hazardous WasteGenerators <br />t <br />in the matter of the Violation cited on: S 123 <br />Im- <br />As <br />Conducted by:. Vpo rte-- [EHD Inspector(s)] <br />I certify under penalty of law that: <br />1. Respondent has corrected the violations specified in the notice of <br />violation cited above. <br />3. Based on i ofthe attached documentation and <br />Inquiry of the individuals who prepared or obtained it, I believe that <br />the information •:complete. <br />5. 1 am aware that there are significant penalties for submitting false <br />Information, including the possibility of tine and imprisonment for <br />knowing violations. <br />Vii `r A 5 PDPrS C o . <br />,1 '` .n <br />AddressFacility <br />i <br />or <br />j 1 9-r e 5� <br />Signature Date Signed <br />EHOCERT (rev 1107102) <br />