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SAN J DAW Environrnental Health Department <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MIND violations noted in [lye"Notice to Comply' in the attached Inspe0an Report must be corrected within 30 0y5 of <br /> receipt of this inspection- This crtrtibcatioil Corm must be submitted to the Environmental Health Department(EHO) address a <br /> the bottom of this form within 30 days of receipt of the Inspection Report. HSC 25404.1.E(c)(1) <br /> All COT re[:tions to U1her vialalions noted in the afta had Ins action Report(IR)or Congnuation Form.or CliSputos to any <br /> violationK, ang to be submitted using this certificatlon anti returned to EHD within 30 days unless otherwise specified in the <br /> Inspection Report. HSC 25185(c)(3) <br /> Mote; All EHV 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, [lie opemior of[he site must include: <br /> A statement documenting what Corrective actions were taken or will Lie taker for each vrolalian <br /> Copies of sample resultsirnarufestsftraining recordsiother appropriate paperwork,andlor photos verifying corroctions <br /> Operator's rtiticz#ion <br /> Inspection Date: May 45, 2026 Inspected By. TORI OKUiV URA <br /> Facility Address: 2440 DANIELSTr MANTECA CERS ID: 1014£p1143 <br /> I certify under penalty of law that. <br /> 1- I have crrrrr;cted the viGlations specified In the Inspection Report from the above4mmioned inspection date- <br /> 2. 1 have personally exarnaireri the fulIowrny rloer,mentalion submitted as prcaf of ccmpllance FOR EACH VIOLATION <br /> and I believeihin information to be truC, accurate, and complete: <br /> Photos X Paperwork . X Staterngrit <br /> 3. 1 am authorized to submii this CefU fication an behalf of thR Ragpnndant. <br /> 4. t am aware that there are significant penalties for submilti ng false information, inch ding than possibility of a file an#fpr <br /> imprisonment for known violations, (HSC 25191} <br /> Name: pa;lvl 0 Title- 0 •s <br /> Signature- Date: <br />