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<br />RETURN TO COMPLIANCE CERTIFICATI(?td
<br />• ��':a F tta+� ry+{x>�9 on4,t,7hlstcortiG utictl iontf0 f n n)li�i'st he'Iubmltir.•d�lu llho f ovule' f men6'�I
<br />nr. ,
<br />;Ms lVrrn wlihat ab da
<br />at ruce)pl o11he lnspeclion Rep,11 HU, 2'-,4UA 1
<br />n r.,'S,y,�?S,I,y� O_IhBr.Ylalaric y noted in fhc rdtnclted Inspecfinn P'.purl (117) nt r;r,ntM10,0t nl h..l, �,..: �.. o„t
<br />to be subnutted using this cellificaflon all() relurnod to Clif)wilhin aU il. �y.
<br />RHipott HSC 25185(c,)(3)
<br />Note: All EHD staff time associated with failing to comply by the ahovo ncNntl rl ,Ir, ; ,,,til Ix1
<br />billed at the current dourly rate.
<br />For this certification to be complete, 1111l opvtorw of 1111• •dh, nin.lw I,,,I,
<br />A statement docutuentinp what cnuechve wfionti wore lal,en "I will hr. I,,brv, Irl,
<br />Copies of sample i esults/rna I"fw,(tJh al ni rill iaculdsJothol algn r,(nuit�� pnl�oiwr�iD un�t!„i ; of tnnl , "n...!um
<br />Inspection Date: Inspected By:
<br />Facility Address: ------ -------..___._.__. CPA ID
<br />F r penalty of law that
<br />e corrected the violations spe.cihed m the, I11"'po mil Rop:nl burn nu• alp ,vr �,,,> I,, .,
<br />e personally examined lho IaBowing docuruonl.niaii bulnn�pr�S ;c. pi„r�t �,1
<br />ve the information to be tme, accurate, and complele
<br />Photos _ papenw)[k, Ultcrnenl
<br />authorized to submit this certification on behalf of the Respondent
<br />ware that there are significant penalties for submitting false inloimation, includin) t u
<br />lnment for known violations. (HSC 25191)
<br />j-tT_ ;Z-1 r -r -7 _Title
<br />--��.-�
<br />Signature:_ l��/moi_ ✓/ ' Date
<br />AUG 10 ?015
<br />ENVIRONMENTAL
<br />14PAI r"f r)CDgPT1ACMT
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