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San Joaquin County <br /> Environmental Health Department <br /> 1858 East Hazelton Avenue, Stockton,California 95205-6232 <br /> Telephone:(209)468-3420 Fan:(209)468-3433 Web.www.sjaov.oro/ehd <br /> RETURN TO COMPLIANCE CR►TI ICI TIO <br /> Any MINOR violations noted in the"Notice to Comply"in the attached Inspection Report must be corrected within 30 dans of <br /> receipt of this inspection. This certification form must be submitted to the Environmental Health Department(EHD)address; <br /> the top of this form within 30 days of receipt of the Inspection Report. HSC 25404.1.2(c)(1) <br /> All sir ctions to other violations noted in the attached Inspection Report(IR)or Continuation Form,or disputes to any <br /> violations,are to be submitted using this certification and returned to EHD within 30 days unless otherwise specified in the <br /> Inspection Report. MSC 25185(c)(3) <br /> Note: All EHD staff time associated with failing to comply by the above noted dates will be <br /> billed at the current hourly rate. <br /> For this certification to be complete, the 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 results/manifeststtraining records/other appropriate paperwork,and/or photos verifying corrections <br /> Inspection Date: March 17, 2015 Inspected By: MICHELLE HENRY <br /> Facility Address: 2360 W GRANT LINE RD, Tracy EPA ID: C a �- c002S`{ 963 <br /> I certify under penalty of law that <br /> 1. 1 have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br /> 1 believe the information to be true,accurate,and complete: <br /> Photos 9 1 Paperwork Statement <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. <br /> 4. 1 am aware that there are significant penalties for submitting false information, including the possibility of a fine and! <br /> imprisonment for known violations. (HSC 25191) k� <br /> Name: AL,�'-,A Title: t` <br /> n <br /> � Z1715 <br /> Signature: 9-�-�_. ®s Date: <br /> t <br />