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stato of California California EnvironrnenL"Alliltection Agency <br />Department of Torr, Substances Control <br />SUMMARY OF VIOLATIONS <br />Facility Name: ► Ire Date: 3 1 � <br />SECTION is VIOLATIONS/NOTICE TO COMPLY <br />Within five working days of achieving compliance, you are required to sign the <br />certification below, and return it to DTSC at the address shown on page 1 in <br />paragraph 2. <br />Failure to correct the violations and certify compliance within the time provided <br />may result in DTSC taking additional enforcement action for these violations. <br />[ ] See Continuation Sheet <br />CERTIFICATION STATEMENT <br />I certify under penalty of law, that the above corrective actions identified above in <br />Section I have been taken and the violations have been corrected. I am aware that <br />there are significant penalties for submitting false information. <br />Signature <br />Title <br />DTSC (3195) <br />Date <br />Page — of <br />