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� 1N <br /> SAN I OQ Q U EnvironmentalHe <br /> COUNTY alth Department <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> ^ray �violations noted in the"Notice to Comply. 'in the <br /> e attached Inspection Re <br /> ,-vipt aFthis inspection This certification form must be submitted to the Environmenttal Health Depa mMUSI be eet Hn 30 da sof <br /> of the tkJ(to111 Of this form WithinyU oayS <br /> j,. Ot receipt Of Ine inspeclio,,rieport, rlJl dJ4U4.F.d C ( d)address <br /> Ail corrections to other vrolati()ns noted in the attach(,d Inspoct�c�n Report(IR)or Continuation Form, or disputes to <br /> violations,are to be submitted using this certification and returned to port wi hon 3o ti s unless otherwise specified <br /> Inspection Report. HSC 25185(c)(3) P any <br /> in the <br /> r�'f�• d!! [�Hf1 etaff tltr:a tteerer!atpr! <br /> With faJlJ iv i-Z•^ts:mtx!v by tive ahmva nntar! !atna uerN <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 /> Operat 's certifrcation„ _,l__ r•• ___ —t- <br /> or -- <br /> �nn:: - -r:-- <br /> Inspection Date: April 26, 2019 <br /> Inspected By: JOHN ALANIZ <br /> Facility Address: 1505 Navy Dr, Stockton <br /> CERS ID: 10642959 <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 /> and I believe the intormatron to 0e true, accurate, and complete <br /> Photos 2CPaperwork <br /> Statement <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. <br /> imprisonment r y iairi niw,-`aiwi,, i,i nuv, ti <br /> nown violations. (HSG 25191) 'y- +"•�� w a;;,,�ac5dtor <br /> Name: <br /> Title: <br /> Signature- <br /> - --------s�Date, l t <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468.34201 F 2 _ <br /> 09 464 0138 I www.slcehd.com <br /> Scanned with CamScanner <br />