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�A NJ 0 A 0 U� Environmental Health Department <br /> I �� UNTY— <br /> `` Greviness grows here. <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violwions noted in ttre -Notice w C imply' 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 EnvlronmentaI Health Department(EHO)address at <br /> the bottom of this farm within 30 days of receipt of the Inspection Report. H S C 25444.1_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 Ibis ce rtificalion and returned to E;H1) within 19 days unless othwwiSe specified in the <br /> Inspection Report. HSC 251Wc)f3) <br /> Mote: All EHD staff time associated with failing to comply by the above rioted dates will be <br /> billed at the current hourly rate. <br /> For this certification to be co rnplet , the operator of the site must include: <br /> A statement documenting what carreclive actions were lakan or wilt be taken for each Valati0n <br /> Capies of sample resutts�rnanifesletraining recordsJother appropriate paperwo.N. anWor photos verifying cormChor%5 <br /> Operator's certificatiion <br /> Inspection Date, February 26, 2025 Inspected By: AARON MADERA <br /> Facility Address: 1002 FRONTAGE RD, RIPON CFRS ID: 10180637 <br /> I oerhfy under penalty of taw that <br /> 1. 1 have corrected the violations specified in the Inspection Repari from the above-mentioned inspection date <br /> 2. 1 have personally examined the fallowing documentation submitted as proof of compliance FOR EACH VIOLATION <br /> and I believe the information to be true, accurate, and complete, <br /> Photos Paperwork Statement <br /> 3. 1 am authorized to submit INN Certifical ion on behalf of the Respondent. <br /> 4, l am aware that there are significant penalties for submitting false information, including the possibility of a fine andlor <br /> imprisonment for known violations. {HSG 251 Di} <br /> Name' Tam 9abeh Title- <br /> Signature: _/L Date: 0� � Z5- <br />