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San Joaquin county <br />Environmental Health DepartmentFIE <br />p1868 East Hazelton Avenue, Stockton, California 95205-6232 Lc' <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: .s' ov. /ehd VEL) <br />RETURN TO COMPLIANCE CERTIFICATIOt1 APR 13 2015 <br />ZNV'f <br />Any MINOR violations noted in the "Notice to Com I in the attached Inspection Report must be cob .wit I <br />receipt of this inspection. This certification form must be submitted to the Environmental Health Department (EHD) aildtrf ss <br />the top of this form within 30 days of receipt of the Inspection Report. MSC 25404.12(c)(1) <br />All correcti as 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 wit in j0 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 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 recordslother appropriate paperwork, and/or photos verifying corrections <br />Inspection Date: <br />March 25, 2015 <br />Inspected By: <br />ELENA MANZO _ <br />Facility Address: <br />1553 COLONY RD RIPON <br />EPA ID: <br />C - (�` (C: C ,p,),C <br />I certify under penalty of law that: <br />1. 1 have corrected the violations specified in the Inspection Report from the above-mentioned inspection date_ <br />2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br />I believe the information to be true, accurate, and co oe�, <br />Photos PaperworkStatement <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 and! <br />imprisonment for known violations- <br />✓(HSC 25191) � j' � <br />Name: 7y eSS� "\ &N Z Title: eS �.0 -�j j t,►'�U ' �v� �VY-I <br />Signature: <br />v �c1&�,1��V-,, ( L <br />Date. 1 _> <br />