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SAN.tIDAQUIN Environmental Health Department <br />COUNTY <br />AMENDED <br />RETURN TO COMPLIANCE CERTIFICATION 20 ,� <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 <br />at the top 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 opemtorofthe site mustinclude: <br />Astatement documenting what corrective actions were taken or will be taken for each violation <br />Copies of sample resullslmanifests/lmining recordslolher appropriate paperwork, and/or photos verifying <br />corrections <br />Operators certification <br />Inspection Date: July 18, 2018 _ Inspected By: CESAR RUVALCABA <br />Facility Address: 1333 E TURNER RD, LODI CERS ID: 10181903 <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. [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 />X Photos X Paperwork X Statement <br />3. 1 am authorized to submit this certification on behalf of the Respondent. <br />4. lam aware that there are significant penalties for submitting false Information, including the possibility of a fine <br />and/or imprisonment for known violations. (HSC 25191) <br />Pineda Tifla- Transfer Station/Mrf Manager <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.$)cehd.com <br />