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04/07/2016 23:30 209943793 WILD HORSES 4X4 PAGE 01/04 <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue. Stockton, California95205-6232 <br /> Telephone:(209)468-3420 Far: (209)468-3433 Web:www.siPov.ora/ehd <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the"Notice to Comply" in the attached Inspection Report most be corrected wifbioA days of <br /> receipt of this inspection. This certification form must be submitted to the Environmental Health Department(EHD) address <br /> the top of this form within 30 days of receipt of the Inspection Report. HSC 25404.1.2(c)(1) <br /> All corrections ions 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 EHDwithin 30 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 resultsrmanifests(training recordslother appropriate paperwork, and/or photos verifying correction: <br /> Inspection Date: March 10 2016 Inspected By. ARTS VELOSO <br /> Facility Address: 1045 S Cherokee Ln Lodi _ EPA ID: CAC oo,2 5g5-38" <br /> I certify under penally 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 /> 1 believe the information to be true, accurate,and complete: <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 ands <br /> imprisonment for known violations. (HSC 25191) <br /> Name: Qc.vtc Seloo1c) Title: Or,Oera7tons ALP%ager <br /> Signature Date- <br /> RIVED <br /> APR 0 8 2016 <br /> ENVit UN.METYAL <br />