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"Notice to Comply" in the attached <br />Inspect <br />on <br />Report must be corrected with i n-ag-d-U—s <br />Any MINOR violations noted in the fication form muust be subm tted to the Envliro mental Health Department (EHD) address f <br />receipt of this inspection. This cern <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 toubmitted us ng this certificationeand returned to EHD IContinuation Form, <br />w thing ys un esn otherwise specified n the <br />violations, are to bee ss <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 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 <br />corrections <br />Operator's certification <br />CESAR RUVALCABA <br />Inspection Date: <br />Facility Address <br />July 31, 2018 Inspected By: <br />2720 Wilcox Rd, Stockton <br />I certify under penalty of law that: <br />I have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br />I have personally examineo d tfollowinaccurate, eand'on submitted as proof of compliance FOR EACH VIOLATION <br />and I believe the information <br />CERS ID: 10654741 <br />2. <br />_Photos _Paperwork Statement <br />3. 1 am authorized to submit this certification on behalf of the Respondent. <br />4. 1 am 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 />e.- Title: <br />Au <br />Name: A <br />e: /a - S' l t <br />Signature: <br />1 363 E. Hazeiton Avenue ! Stockton, California 952051 T 209 463-3420 1 F 209 464-0138 1 vNvw.s cehd.com <br />