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x w. „ <br />:°ai EPJ4, GRAY DAVIS, Govem� <br />$M <br />S <br />Al <br />TI <br />R T F'ICATI y l� 'k tUWMc )MPLIANCE <br />n.. <br />For" Permit by ule,= Conditionnally Authoti�ed,rand :Conditionally Exempt <br />Notfers <br />In the matter of the Violation cited on <br />Located at: �'' ✓� [4LW4-ei (facility address) <br />As Identified in the Inspection Report dated <br />Conducted by: S7GEHp (agency(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 />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 <br />of the individuals who prepared or obtained it, I believe that the <br />information 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 <br />,knowing violations. <br />Name (Print or Type) Title <br />/ 0 <br />Signature Date Signed <br />Lo 7 <br />C' 373 <br />Company Name EPA•ID. Number <br />Revised 3/5/02 <br />