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S AN J O A Q U I N Environmental Health Department <br />COUNTY <br />i <br />RETURN TO COMPLIANCE CERTIFICATION <br />Any MINOR violations noted in <br />the "Notice to Comply" <br />in the attached Inspection Report <br />must be corrected within 30 days of <br />receipt of this inspection. This <br />certification form must <br />be submitted to the Environmental <br />Health Department (EHD) address at <br />the bottom of this form within 30 days of receipt of the <br />Inspection Report. HSC 25404.1.2(c)(1) <br />All corrections to other violations noted in the attached Inspection <br />Report (IR) or <br />Continuation Form, or disputes to any <br />violations, <br />are to be submitted using this certification and returned <br />to EHD within <br />30 days unless otherwise specified in the <br />Inspection <br />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: February 19, 2025 Inspected By: <br />Facility Address: <br />HAZA SAEED <br />14700 W SCHULTE RD, TRACY CERS ID: 10153919 <br />I certify under penally of law that: <br />1. I have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br />2. I have personally examined the following documentation submitted as proof of compliance <br />FOR EACH VIOLATION <br />and I believe the information to be true, accurate, and complete: <br />Photos K Paperwork X Statement <br />3. I am authorized to submit this certification on behalf of the Respondent. <br />4. I am aware that there are significant <br />penalties for submitting false information, including the possibility of a fine and/or <br />imprisonment for known v�iorlations. (HSC 25191) I f, <br />Name: C.10 I(kU l�,(9&0 ll Title: 6 \A(0\rr\42Ajet, r`G^I��PQr <br />Signature: J\t�1��l�ti �1� Date: 3' <br />