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. 08/04/2015 07:16 5106571544 QUIK STOP MARKETS PAGE 02/09 <br /> San Joaquin County <br /> Environmental He. Department <br /> 1868 East Hazelton Avenue, Stockton, Galdomia95205_62 <br /> V o 1ehd AUG 0 4 2015 <br /> Telephone:(209)468-3420 Fax; (209)4683433 Web:w� — <br /> RETURN TO COMPLIANCE CERTIFICATION 101AInrN1M1l:NVTAL <br /> Any MINOR violations noted in the"Notice to Comply"in the attached Inspection Report must be epa ed <br /> within 30 d sof <br /> form within 30 days of receipt of the inspection Report. HSC.25404.1.2(c)(1) <br /> receipt of this inspection. This certification form must be submitted to the Environmental Health Department(EHD) address <br /> the top of this any <br /> Report IR or Continuation Form, or disputes o <br /> ithin 3o dmfs unless otherwise specified in the <br /> All corrections to other violations noted in the attached Inspection Repo <br /> violations, are to be submitted using this certification and returned to EHthN <br /> inspection Report- H80 25185(c)(3) <br /> failing to comply by the above noted dates will be <br /> Nie; All EHD staff time associated with <br /> billed at the current hourly <br /> rate. <br /> For this certification to be camp <br /> lete,the operator of the site must include: <br /> were taken o will be tae rwork and/or photos verifying correction: <br /> ach violation, <br /> A statement documenting what corrective a e'c rdslother appropriate papa <br /> Copies of sample resuitslmanifests/training NICHOLAS LOEHRER <br /> Inspected BY: <br /> Inspection Date: Jul 09 2015 EPA IIx <br /> Facility Address: 505 N MAIN ST MANTECA <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 have personally examined the following documentation submitted <br /> as proof of compliance FOR EACH VIOi P TIO <br /> I believe the information to be true, accurate, and complete: <br /> Photos <br /> Paperwork L'Statement <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. <br /> s o informallon, including the possibility of a fine ana <br /> 4. 1 am aware that there are significant penalties for submitting <br /> Sc 25191) <br /> implis�menttorknownviolatiorrs. M <br /> tip . BftT <br /> Title: <br /> Name: <br /> Date_ <br /> Signature: <br />