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San ,toaqulrl Cuggty <br />Enwironmenfdl Health Depatrr%nt <br />1B30 East Haaefipn Awnus, $tdsahtor f 811FCmis SVZL54= <br />T19MOf ger U(Y-} 4C�B-MM Far; (200) 46&?A33 fth, �yvm. �y� cralehd <br />RETURN To COMPLIANCE CERTIFICATION <br />Any PAl� viDlahb" na#ed in the "Nokite to ODnIPY in the atl"ed Inspes n. Report mist he ayj2�5,6ea w► him 3(I da' s hF <br />receipt of this Irmivaticn. Thie oe,Ur.a%1 fern moat ha subrrrbsd to me Environmeft Heap Cnparsmen+. {0 11)) a+ sr s <br />st UNa top of this 10-n Vthlh 30 days OF ra N Of fhb Inepeeflon ftaport HSC 25404. f.2(rJ 1) <br />Arr vi ' n noted in LV aMc:ged InSMffiian <br />uiolaGOflS, are to IA Subrn 11M uain tis oertir SEH fiRj ar €; doff unt Form, or 4rsputee ea sirr <br />r 9t �r1d requnlBtl ! PHR smfeas aiherwise speC�l9d d y lay <br />rnOn Report rySG 2.�185(O}f3! <br />Nfytle; AIJ E110 staff U1116 mmotioted with faiJiing It, �-'MPIY by #Me- above noted dits will be <br />billed at the current hourly rata. <br />For thIs cerfifica# on to be complete, it,& aper[« of tee safe muss InFludo: <br />A sWornent acro Yantigg wharf cormuNl' Acta— w token or will Du taken for each V&SIlon <br />EopEn # sanple rmwlt5rmenif Jaining re44tc otherapp posse POIN work. andlo' photae'roriryirg <br />ccm «tions <br />Inapaatiw data, Ncamber ,14, dill i Insp$cte€# By: JOHN ALAN 1Z <br />Facility Address-. _M38 S EL C)()[R. DC) S'I', FLt!_: [;FI SAMA CFRt IA- Ifl1.WsAz <br />i Gertffy un:igrpenalty & law f mt. <br />y. I a,vs corre0ed the vim!WiOns 21—if*q irI ;he Inspe0lan Report NY0 tha abam-mentiona. Inspe oh data. <br />' h2'+B parsonaky examined 0ofO4lcwi!e9 doaunentahon submided es af"Fof Ycn "POR EA(CJd MLA7FON <br />Qnd I bel+eW Iho inbrnation !o he tus, aXuratlx andcwplete: <br />Phatoe PeperwoFlc _St8lorest+t <br />3. 137n auLhorIZM to auhmi 1h IS Cwtifra ban 411 Uhalf of the kaspandent. <br />4. I am swore that ihere Wb r, r� Aosn. Molrias farsuOi4tlrg False -nformation. including the ftd4 uF a flne <br />snd1w impfanm forknovm Vick'' a --{HSC. 26191) <br />Hama_ r Wr 1 Tifba: () <br />igrlattlt* _ - _ —Date: + J i <br />