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03/09/2010 14:34 12099438661 <br />. 0 <br />CHP STOCKTON <br />11 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, StocXton, CA 95202-3029 <br />O_Fay�_(209) 468-3433 Web; mmm,siaw.orafehd <br />ii 177=111 I <br />PAGE 15/15 <br />'A"AR1411R, 4,11110W A - - <br />old 6"�jt zz <br />RINI <br />INALL2 W <br />WWWKI <br />Envi Pon menWAWKf <br />inspection Report. <br />TO mwlmv -Mm I A3L75T'_M%W7 <br />disputes to any violations, are to De suommea ALSing <br />unless otherwise specified in the Inspection Report. <br />Note: All EHD staff time associated with failing to comply by the above noted dates Will b_ ­ <br />billed at the current hourly rate. <br />For this certification to be completethe operator of the site must include: <br />A statement documenting what corrective actions were taken or will be tAken for each Violation <br />Copies of sample resulWmanifests/training records/other appropriate paperwork, and/or photos <br />verifying corrections <br />Operator's certification <br />I mimn��E wARM <br />I i <br />Facility Address: 3 �_SpgA4 AP* Aji4& <br />Inspected By: <br />EPA ID#. IJ� <br />I have corrected the violations specified in the Inspection Report from the above-mentioned <br />inspection date. <br />2. 1 have personally examined the following documentation submitted as proof of compliance FOR <br />EACW VIOLATION and I believe the information to be true, accurate, and complete: <br />Photos Paperwork _,�( statemen, <br />I am aware that there are significant penalties for submitting false information, including the <br />possibility of a fine and/or imprisonment for known violations. (HSC 25191) <br />I--,' <br />Name: Q len- <br />1*T7TMWZ7JMe <br />