Laserfiche WebLink
STATE OF CALIFORNIA-ENVIRONMENTAL PROTECTION AGENCY PETE WILSON, GovernoF <br /> DEPARTMENT OF TOXIC SUBST ICES CONTROL <br /> REGION 1-10151 Croydon Way, Suite 3� <br /> Sacramento, CA 95827 <br /> TIERED PF.RMiTHN(* <br /> CFRTiFICATION OF RFT'ITRN TO COMPTJANCF. <br /> For Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers <br /> In the matter of the Violation cited on : to qhS <br /> As Identified in the Inspection Report dated to y <br /> Conducted by Lc-, wdL_ (agency(s)) <br /> I certify under penalty of law that: <br /> 1. Respondent has corrected the violations specified in the notice of violation cited <br /> above. <br /> 2. I have personally examined any documentation attached to the certification to <br /> establish that the violations have been corrected. <br /> 3. Based on my examination of the attached documentation and inquiry of the <br /> individuals who prepared or obtained it, I believe that the information is true, <br /> accurate, and complete. <br /> 4. I am authorized to file this certification on behalf of the Respondent. <br /> 5. I am aware that there are significant penalties for submitting false information, <br /> including the possibility of fine and imprisonment for knowing violations. <br /> �rV— <br /> N (Print or Type) Title v <br /> Signature Date Signed <br /> &UAL,-x INS CAL, 0000 Iq? CIO -1- <br /> Company Name EPA ID. Number <br /> DTSC-REiCOMP.CRT(8/94) <br />