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PURL HEALTH SER110ES <br />SAN JOAQUIN COUNTY <br />ENVIRONMiENTAL HEALTH DIVISION <br />Ernest M. Fujimoto, M.D., iM_F.H., Acting Health Officer <br />304 E.Weber Ave., 3rd Floor a P. 0. Box 388 • Stockton. CA 95201-0388 <br />209/40-3424 <br />CERTIFICATION OF RUMN TO CQMPLiANCE <br />In the matter of the Violation(s) cited on i -15-q 7 Z/ 7 <br />As Identified in the Inspection Report dated V f5`1 I- 46.77 <br />,�AqurN. <br />Coo,a� <br />Conducted by u rs 17`eal cruc� <br />r, �+ o� ��� (ageZ or agencies) <br />I certify under pen21ty of law that: <br />1. Respondent has corrected the violations specified in the notice of violation cited <br />above. <br />2. 1 have personally examined any documentation attached to the certification to <br />establish that the violations have been corrected. <br />3. Based on my examination of the attached documentation and inquiry of the <br />individuais who prepared or obtained it, I believe that the information is true, <br />aocurate, and complete_ <br />4. 1 am authorized to file this certification on behalf of the Respondeat. <br />5. 1 am aware that there are significant penalties for submitting false information, <br />including the passibility of fine and imprisonment for knowing violations. <br />Name (Print or Type) Title <br />s4a, <br />5i ure Date Signed <br />Company blame EPA ID. Number <br />A Mvis4en of San Jo"vin County HMtb Care Servitrs <br />