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Cal -E. <br />SAN JOAQUIN COUNTY UNIFIED PROGRAM AGENCY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 E MAIN ST. <br />STOCKTON, CA 95202-3029 <br />40 - <br />Edmund G. Brown. Jr., Governor <br />TIERED PERMITTING <br />CERTIFICATION OF RETURN TO COMPLUNCE <br />For Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifters <br />(I � <br />In the matter of the Violation cited on: rT <br />Located at:4Z/ <br />(facility address) <br />As Identified in the Inspection Report dated <br />Conducted by: <br />I certify under penalty of law that: <br />J U L, <br />,20 E 6 -a 6 E=' <br />W41WIL �j i I <br />LEZ�AAIW I "' : i j L I <br />1. Respondent has corrected the violations specified in the notice of violation cited <br />above. <br />2. 1 have personally examined any documentation attached to the certification to <br />establish that the violations have been corrected. <br />3. Based on my examination of the attached documentation and Inquiry of the <br />Individuals who prepared or obtained it, I believe that the information is true, <br />accurate, and complete. <br />4. 1 am authorized to file this certification on behalf of the Respondent <br />5. 1 am aware that there are significant penalties for submitting false information, <br />including the possibility of fine and imprisonment for knowing violations. <br />Name (Print or Type li title <br />Signature Date Signed <br />U <br />Lali 000d, 76 3 7 <br />Company Name EPA ID. Number <br />Revised 01/2412011 <br />