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07/1412010 13:18 9164431276 <br />102454 9 <br />RETAIL <br />n <br />SAN JoAQuIm CouwrY <br />ENVIRONMENTAL <br />:00 East Mein Streek Stockton,r: <br />r•I A�• �; .y .•. # . <br />PAGE 01/01 <br />• ilollPUIA <br />Inspection Report. <br />fit <br />disputes to any violations, are to be submitted Using tniS COrtmC311011 <br />unless oftwwise specified In the Inspection1♦ <br />note: 711 tinx 1,776 <br />billed at + <br />,;-or this certification to be complete theoperator of ft site must include. <br />A statement documenting what corrective actions were taken or will be taken for each violati <br />verifying corrections <br />Inspection Date. l , Hca Inspected By: Nis <br />Facility Address: <br />1 certify under penalty of lav that: l- ti <-N <br />I have corrected the Violations specified in the Iropedon Report from the above-mentioned <br />inspection date. <br />2, 1 have personally examined the following documentation submitted as Proof Of compliance FOR <br />a <br />CH \110LATION and I believe the1rifOrmatiOn' to be true, accurate, and complete: <br />Photos --M—PaPerwolic Statement <br />4 1 am "are ftw there are significant penalties for submitting false information, induding the <br />possibility of • •r imprisonment for• ► • <br />ns. (HSC 25191) <br />Date' .'7 /% <br />END 22.02#}8 ReV QWOB <br />WW. <br />