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SEP -18-2006 MON 09:43 AM 01s STOP MARKETS FAX NO. 51 71544 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 East Weber Avenue, 3`4 Floor, Stockton, CA 95242-2703 <br />Telephone: (209) 468-3420 Fax. (209) 468-3433 Web: www.stia ®: gel} <br />s <br />P. 02 <br />':! j,c� <br />Any bul 4qR violations noted in the "Notice to Comply" in the attached inspect on repoi I must be <br />correctec l within 30 da s of receipt of this inspection. This certification form m tst be su . mitted to the <br />Environs mental Health Department (EHD) address at the top of this form within '35 days f receipt of the <br />inspec:tic n report. <br />All qgm ctions to other violations noted in the attached inspection Report (IR) c r Contin t ation Form, or <br />disputes to any violations, are to be submitted using this certification and return d to EH I t within 60 days <br />uniests o herwise specified in the IR. <br />For t% Lis certification t0 be, completethe operator of the site m; tst incl 4-: <br />k statement documenting what corrective actions were taken or will be taken fo - each violation <br />® opies of sample results/manifests/training records/other appropriate p: perwo and/or photos <br />verifying corrections <br />* aperator's certification <br />Inspvc' ion Date:-- Inspected By:— <br />Faci:lit i Address: ®.7—IJ,c� � �K9 EPA ILi#: RC, <br />1 cc rtify under penalty of law that: <br />�.. I have corrected the violations specified in the inspection Report from ' he <br />inspection date. <br />>.. I have personally examined the following documentation submitted as proof <br />EACH VIOLATION and I believe the information to be true, accurate, and c <br />Photos *0'0Paperwork /Stater; gent <br />3. Yam authorized to submit this certification on behalf of the Respondert. <br />4. I am aware that there are significant penalties for submitting false info znation, <br />possibility of a fine and/or imprisonment for known violations. (HSC 5191) <br />514znature: Xt, � A ✓rc"�+rP, Date: <br />mentioned <br />ompliance FOR <br />Mete: <br />J acluding the <br />