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Page 2 of 2 <br />9 9 <br />inspection date. <br />2. I have personally examined the following documentation submitted as proof of compliance <br />FOR <br />EACH VIOLATION and I believe the information to be true, accurate, and complete: <br />Photos Paperwork Statement <br />3. I am authorized to submit this certification on behalf of the Respondent. <br />the <br />4. I am aware that there are significant penalties for submitting false information, including <br />possibility of a fine and/or imprisonment for known violations. (HSC 25191) <br />Name: <br />Si <br />Title: <br />Date: <br />I have received the statement from Alex Jabbari about the L4 87 annular alarm that occurred on 12-31-08. <br />Submit corrective action statements for violations # 7 that maintenance and monitoring records will be kept <br />readily available for review. <br />Thank you, <br />Aris Cacapit, EHs <br />San Joaquin County Environmental Health Department <br />600 E. Main St. <br />Stockton, CA 95202 <br />(209) 468-3453 desk <br />(209) 468-3433 fax <br />4/24/2009 <br />