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2018-11-20 13:04 Sunwest Chevron 2758 >> 2044683433 P 1/7 <br /> San Joaquin County l `, T, <br /> Environmental Health Department NOV o <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 2018 <br /> Telephone.(209)468-3420 Fax:(209)468.3433 Web:www.jigov.org/ehd/ehd <br /> RETURN TO COMPLIANCE CERTIFICATION Wf11TH ,-, TiMFNT <br /> Any MINOR violations noted in the"Notice to Comply"in the attached Inspection Report must be corrected ithin 30 da s 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 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/manfests/training records/other appropriate paperwork,and/or photos verifying corrections <br /> Inspection pate: October 17, 2018 Inspected By: STACY RIVERA <br /> Facility Address: 2758 W Kettleman Ln, Lodi CERS ID: 10748068 <br /> 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 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) <br /> Name: ruml rtm Title: qtuA_0(_�' <br /> Signature: —Date:— Z 1,10 8 <br />