Laserfiche WebLink
Dec 0219 01 ; 54p R& A Miller , Inc . 209 931 -8832 p . 2 <br /> San Joaquin County <br /> v <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue , Stockton , California 952105-6232 Telephone : <br /> (209) 468-3420 Fax: (209) 468-3433 Web : www.sigov . orq/ehd <br /> RETURN TO COMPLIANCE CE TIFICA NAvTNA E �L I <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 /> ,-. 11 corrections to other violations noted in the attached Inspection Report (IR) or Continuation Form , or disputes to any <br /> to be su 'orni " ed using this certification and returned to EHD within 310 days unless otherwise specified in the <br /> r% 0Mnt }� bt the above noted dates will be <br /> � Z3i� � ilOf1 ; G iDc COCT1p � E;I2 ; the operator of the site must include : <br /> =, sI �ZtL.- snt 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 <br /> corrections <br /> Operator' s certification <br /> Christine Lawrence B . <br /> Inspection Date : August 27 , 2019 Inspected � � <br /> Facility Address ; 14063 E COMSTOCK CERS ID : 1oi36133 <br /> I certify under penalty of law that: <br /> 1 . I 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 <br /> VIOLATION and I believe the information to be true , accurate , and complete : <br /> Photos l� Paperwork _ Statement <br /> s_ L t is certification on behalf of the Respondent . <br /> penaltiesfor submitting false information , including the possibility of a me <br /> andior irn isonment for known violations . ( HSC 25191 ) <br /> (Name : Title : � � -� <br /> - - -- - - <br /> Signatur , :� Y, <br /> a l ° pt Date : <br /> ` <br />