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S A J O A 4 U I N Environmental Health Department RETURN TO COMPLIANCE CERTIFICATION Any MINOR viol tions noted in the"Notice to Comply" in the attached Inspection Report must be corrected within 30 days of receipt of this in pection. This certification form must be submitted to the Environmental Health Department (EHD) address at the bottom of thi form within 30 days of receipt of the Inspection Report. HSC 25404.1.2(c)(1) All corrections tc 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 days unless otherwise specified in the Inspection Repo 1. HSC 25185(c)(3) Note: Al 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. April 15, 2021 Inspected By: CAROL PRESTO Facility Add ess: 10715 Trinity Pkwy, Stockton CERS 1D: 10760026 1 certify under p analty 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 teileve the information to be true, accurate, and complete: Photos X Paperwork Statement 3. 1 am uthorized to submit this certification on behalf of the Respondent. 4. 1 am 4 were that there are significant penalties for submitting false information, including the possibility of a fine andlor imprisonment for known violations. (HSC 25191) Name: Fo_� d �,Q0a Title: Signature, Date. 2 ��/