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Jul 30 18 11:56a <br />Ron's Auto Service <br />(209)366-2214 <br />can Joaquin County <br />Environmental Health Department <br />186 <br />East Hazelton Avenue, Stockton, California <br />p.1 <br />Caldamra 95205-6232 <br />Tefephonw (209) 468-3420 Fax! (209) 468-3433 Web: v, rww.slgov.grglehd j 1, 0 7 M <br />I2E I URN TL) GUM VLIANCE CERTIFICA I [UN NVIROWAENTAL <br />Tpii FF'.ARTMENT <br />Any MIN013 violations noted In the "Notice to Comply" in the attached Inspection Report must be gg rected within 30 days of <br />receipt of this inspection. This certification form must be submitted to the Environmental Health Department (EHD) address <br />at the top of this form within 30 days of receipt of the Inspection Report. HSC 25404.1.2(6)(1) <br />All oarredians (4 o#t►er a' tions 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 $Q days unless otherwise specified in the <br />Inspection Report. HSC 25185(c)(3) <br />Note: All EWD staff time associated with faiiin� to comply by the above noted dates will be <br />billed at the current hourly <br />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 violation <br />Copies of sample results/manifests/training recordslother appropriate paperwork, and/or photos verifying <br />corrections <br />Operator's certification <br />Inspection Date: March 16, 2017 Inspected Cyt Stacy Rivera <br />Facility Address: 25560 N HWY 99 CERS ID: 10422952 <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 terve personally examined the fofiowing documentation submitt <br />ed as proof of compliance FOR EACH Vi0[.ATION <br />and I believe the information to be true, accurate, and complete: <br />Photos Paperwork Statement <br />3. I am authorized to submit this certification on behalf of the Respondent. <br />4. I am aware that there are significant penalties for submitting false informati <br />on, including the possibirity of a fine <br />andlor imp�isanmeni for known violations. (HSC 25191) <br />Ofi it ti9al�a � r? r <br />'T/. <br />C� <br />