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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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2200 - Hazardous Waste Program
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PR0514417
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
7/6/2020 2:21:39 PM
Creation date
6/23/2020 6:29:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0514417
PE
2220
FACILITY_ID
FA0010784
FACILITY_NAME
SHAPE INC
STREET_NUMBER
119
STREET_NAME
VAL DERVIN
STREET_TYPE
PKWY
City
STOCKTON
Zip
95206
APN
19337008
CURRENT_STATUS
01
SITE_LOCATION
119 VAL DERVIN PKWY # 2
QC Status
Approved
Scanner
KBlackwell
Supplemental fields
FilePath
\MIGRATIONS\HW\HW_2220_PR0529941_30092 E ORANGE_.tif
Tags
EHD - Public
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i <br /> SAN 3OAQUIN COUNTY UNIFI PROGRAM AGENCY <br /> ENVIRONMENTAL HEALTH D8WRTMENT • <br /> 304 E.WEBER AVENUE <br /> STOCKTON, CA 95202 <br /> JIJL <br /> CERTIFICATION OF RETURN TO COMPLIANCE ENVIR 2 9 2004 <br /> For Hazardous Waste Generators PERM SE rHEACTH <br /> RvlciS <br /> In the matter of the Violation cited on <br /> As Identified in the Inspection Report dated )5j 1-0 <br /> Conducted by [EHD Inspector(s)] <br /> I certify under penalty of law that: <br /> 1. Respondent has corrected the violations specified in the notice of violation <br /> cited above. <br /> 2. I have personally examined any documentation attached to the <br /> certification to establish that the violations have been corrected. <br /> 3. Based on my examination of the attached documentation and inquiry of <br /> the individuals who prepared or obtained it, I believe that the information <br /> is true, accurate, and complete. <br /> 4. I am authorized to file this certification on behalf of the Respondent. <br /> 5. I am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment for knowing <br /> violations. <br /> ''Iu lO <br /> Facility Address EPA ID. Number <br /> Name (Print or Type) Title <br /> Signature Date Signed <br /> EHDCERT(rev 1/07/02) <br />
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