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COMPLIANCE INFO_2021
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1900 - Hazardous Materials Program
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PR0513033
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COMPLIANCE INFO_2021
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Last modified
10/19/2021 1:28:12 PM
Creation date
8/19/2021 4:07:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
2021
RECORD_ID
PR0513033
PE
1921
FACILITY_ID
FA0010745
FACILITY_NAME
PG&E VALLEY HOME SUBSTATION
STREET_NUMBER
12051
Direction
S
STREET_NAME
HENRY
STREET_TYPE
RD
City
OAKDALE
Zip
95361
APN
207-220-03
CURRENT_STATUS
01
SITE_LOCATION
12051 S HENRY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\kblackwell
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EHD - Public
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SANJOAQUIEnvironmental Health Department <br /> N <br /> ry ��&K� COUNTY <br /> {1FOia.. <br /> Greatness grows here, <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the"Notice to Comply"in the attached Inspection Report must be corrected within 30 days of <br /> receipt of this inspection. This certification form must be submitted to the Environmental Health Department(EHD)address at <br /> the bottom of this form within 30 days of receipt of the Inspection Report. HSC 25404.1.2(c)(1) <br /> All corrections to other violations noted in the attached Inspection Report(IR)or Continuation Form, or disputes to any <br /> violations, are to be submitted using this certification and returned to EHD within 30 days unless otherwise 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 will be taken for each violation <br /> Copies of sample results/manifests/training records/other appropriate paperwork, and/or photos verifying corrections <br /> Operator's certification <br /> Inspection Date: August 11, 2021 Inspected By: NICHOLAS LOEHRER <br /> Facility Address: 12051 S HENRY RD, OAKDALE CERS ID: 10148495 <br /> 1 certify under penalty of law that: <br /> 1. 1 have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br /> and I believe the information to be true, accurate, and complete: <br /> Photos Paperwork X Statement <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. <br /> 4. 1 am aware that there are significant penalties for submitting false information, including the possibility of a fine and/or <br /> imprisonment for known violations. (HSC 25191) <br /> Name: Sheilah Lillie Title: Senior Environmental Scientist <br /> Signature: �L Date: 9/3/21 <br />
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