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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue , Stockton , California 95205 -6232 <br /> Telephone: (209 ) 468 - 3420 Fax : (209 ) 468 -3433 Web; www. sigov . org/ehd <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the " Notice to Comply" in the attached Inspection Report must be corrected within 30 days of <br /> receipt of this inspection . This certification form must be submitted to the Environmental Health Department ( EHD ) address <br /> at the top of this form within 30 days of receipt of the Inspection Report, HSC 25404 . 1 . 2 ( c) ( 1 ) <br /> All corrections 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 . HSC 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/manifests/training records/other appropriate paperwork , and/or photos verifying corrections <br /> Inspection Date : January 08 , 2019 Inspected By : GARRETT BACKUS <br /> Facility Address : 1255 S Beckman Rd , Lodi EPA ID. <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 information to be true , accurate , and complete : <br /> Photos 6 Paperwork � Statement <br /> 3 . 1 am authorized to submit this certification on behalf of the Respondent. <br /> 4 . 1 am aware th there are significant penalties for submitting false information , including the possibility of a fine and/ <br /> imprisonment or kno n viol i s . 19 <br /> Name : Title : P4 r 2S <br /> Signature : / Date: <br /> Lodi Chrysler Dodge Jeep Ram <br /> 1255 South Beckman Road , Lodi , CA 95240 <br /> RAM <br /> REC � 11�ee �� <br /> Weston Boeding <br /> �o __ <br /> Parts and Service Director F crwB 2 019r <br /> Business : 209-263-3999 ENVIRONMENTAL HEALTH <br /> Fax: 209-368-2061 PER[ (SERVICES <br /> wboeding@LodiCDJR . com <br /> www. lodicdjr. com <br />