Laserfiche WebLink
SAN J O A Q U I N Environmental Health Department <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(END)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 Farm,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 vlot ation <br /> Copies of sample results/manifestsltraining records/other appropriate paperwork,and/or photos verifying <br /> corrections <br /> Operator's certification <br /> Inspection Date: March 11, 2019 Inspected By: JASON GAITAN <br /> Facility Address: 3190 AUTO CENTER CIR, STOCKTON CERS ID: 10185019 <br /> 1 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 fallowing documentation submitted as proof of compliance FOR EACH VIOLATION <br /> and 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 <br /> and/or imprisonment for known violations. (HSC 25191) <br /> Nam aL\�L Title: ' <br /> Signat e: lc�� __.Date: ' <br /> 1868 E. Hazelton Avenue I Stockton, California 96205 1 T 209 458-3420 1 F 209 464-0136 f www,sjcehd.com <br />