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SANJOAQUIN Environmental Health Department ` -- C O U N T Y _._.. .. . (�acaPr� ess grows herr . RETURN TO COMPLIANCE CERTIFICATION Any MINOR violations noted In the "Notice to Comply" in the attached Inspection Report must be offected within 30 days of receipt of this inspection . This certification form must be submitted to the Environmental Health Department (EHD) address at the bottom of this form within 30 days of receipt of the Inspection Report, HSC 25404. 1 .2(c)(1 ) All corrections to other violations noted in the attached Inspection Report (IR) or Continuation Form , or disputes to any violations, are to be submitted using this certification and returned to EHD within 30 dayg unless otherwise specified in the Inspection Report. HSC 25185(c)(3) Note : All EHD staff time associated with failing to comply by the above noted dates will be billed at the current hourly rate . For this Certification to be complete , the operator of the site must include: A statement documenting what corrective actions were taken or will be taken for each violation Copies of sample results/manifests/training records/other appropriate paperwork , and/or photos verifying corrections Operator's certification Inspection Date : January 07, 2021 inspected By: PAUL NSO Facility Address: 15600 S HARLAN RD , LATHROP CERS ID: 10180541 I certify under penalty of law that: 1 . 1 have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. 2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION and I believe the information to be true, accurate, and complete: PhotosPaperwork _Statement 3. 1 am authorized to submit this certification on behalf of the Respondent. 4a i am aware that there are significant penalties for submitting false information , including the possibility of a fine and/or imprisonment for knownvia tions. (HSC 25191 ) SAO Name: A/4 Title: M Signature: Date. ,