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02.+'23,'2011 15;33Tuff Boy Sales 'nc, Lathrop <br />•,1 <br />(F,AX)209 858 2835 P.002r'002 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL H1=ALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd <br />RETURN TO COMPLIANCE CERTIFICATION <br />Any MINOR violations noted in the "Notice to Comply" in the attached Inspection Report must be <br />corrected within 30 days of receipt of this inspection. This certification form must be submitted to the <br />1=nvironmental Health Department (EHD) address at the top of this form within 30 days of receipt of the <br />Inspection Report. <br />All corrections to other violations noted in the attached inspection Report (IR) or Continuation Form, or <br />disputes to any violations, are to be submitted using this certification and returned to EHD within 30 days <br />unless otherwise specified in the Inspection Report. <br />Note: All EHD staff time associated with falling to comply by the above noted dates will be <br />billed at the current hourly rate. <br />For this Certification t0 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 <br />verifying corrections <br />Operator's certification <br />inspection Date: 11-8-10 <br />Inspected By: Thuy Tran <br />Facility Address: 3870 W. Yosemite Ave EPA ID#: CAL000043238 <br />Lathrop, Ca 95330 <br />I certify under penalty of law that: <br />1. 1 have corrected the violations specified in the Inspection Report from the above-mentloned <br />inspection date. <br />2. 1 have personally examined the following documentation submitted as proof of compliance FOR <br />EACH VIOLATION and I believe the information to be true, accurate, and complete: <br />%� Photos X Paperwork X 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 <br />possibility of a fine and/or imprisonment for known violations, (MSC 25191) <br />Name: Bryce Perkins <br />Sianature: <br />EHD 22-02.005 Rev X0109 <br />Title: Compliance/Safety Mgr <br />Date: 2/28/11 <br />