Laserfiche WebLink
SAN JOAQUIN CQUNtY <br />INVIRONMWAt HkAtltIMPAHIMM <br />1868 test Hasslton Avenue, 81at3k10n, (:a4fnnila uaaofl 00" <br />itelephoesr (200) 46!!•3420 Pax: (20D) 460,34311rYsm WWW.AlUUY.ulU/iill <br />RETURN TO COMPLIANCE CERTIFICATION <br />Any MIho violations noted in the 'Notice to Comply" in the attached Inspection Report mill he <br />c�rrte +d Ycthin 30 dwa of receipt of this Inspection. This catt+Hcanon form maul be uihmntMrl Io the <br />Environn»ntsl Hsrith pspartmsni (END) address at the top of this form within 30 days ut ('11i of the <br />inspection Report. HSC 25404.1 2(c)(1) <br />AN na to gtW vicadLQU noted In the attached inspection Report (11111) or Continuation Marro, or <br />disputa to any violations, are to be submitted using this certification and returned to Ir;HD W11h1f1N.d/YM <br />unless otherwise specified in the Inspection Report HSC26185(03) <br />Nob: All EHD staff time associated with falling to comply by the above noted dates will he <br />billed at the current hourly rate. <br />For this certification t0 be complete the operator or the sue must include <br />• A statement documenting what corrective actions were taken or will be taken for each violation <br />• Copies of sample resule/manifostsAraining records/other appropriate paperwork, andlar photos <br />m <br />verifying corrections <br />• Operator's certification <br />Inspect* BZereof <br />Inspectiony: Date: 1 U 7.Z ' ��3 —^ <br />Faculty Address: 3077 E. Hammer Lane EPA IDs. <br />I certify under penalty of low that: <br />CAL000390123 <br />1. I have corrected the violations specified in the Inspection Report from the above-mentioned <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 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 <br />possibility of a fine and/or imprisonment for known violations. (NSC 25191) <br />C Pn c, r pr(z--- <br />EHD 22-0200$ riev CU79112 <br />Title: �EWU)L WorAe. L _.14. <br />Date: ()) / 2 } / 7 () Ips <br />