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Environmental Health Department <br /> SANAAWIN <br /> COUNTY--- <br /> ,rectness grows here <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the"Notice <br /> n the attached Inspection Report must be corrected within 30 add ssf <br /> to Comply' <br /> form <br /> receipt of this inspetion. This <br /> of th scform within 301days of receipt ofmustthe Inspection be submitted tReport Environmentalthe HSC 25404 Health I,EHD <br /> at the boltor disputes to any <br /> All corrections to other violations noted in the attached Inspection Report(IR)or Continuation Form, <br /> ing this certification and returned to EHD within 30 days unless otherw <br /> violations,are to be submitted usise 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 willb paperwork,and/or photos verifying <br /> be taken for each violation <br /> corrections <br /> Copies of sample results/manifests/training records/other appropriate <br /> Operator's certification ' <br /> Inspected By: JOHN ALANIZ <br /> Inspection Date: June 03, 2019 <br /> CERS ID: 10187767 <br /> Facility Address: 5121 HOLIDAY DR, STOCKTON <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. I have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br /> compl <br /> and I believe the information to be true,accurate,and ete: <br /> _Photos _Paperwork Statement <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. <br /> 4. <br /> I am aware that there are significant penalties for submitting false information,including the possibility of a fine andlor <br /> imprisonment for known violations. ( SC 25191) <br /> l ' � Title: <br /> Name: 60f'w <br /> Date: �(J <br /> Signa <br /> 1868 E. Hazelton Avenue I <br /> Stockton, California 95205 T 249 468-3420 I F 209 464-0138 � wwwsjcehd.com <br />