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SAN JOAQUIN COUNTY UNIEI&PROGRAM AGENCY <br /> ENVIRONMENTAL HEALTH DI%7 ION <br /> 304 E. WESER AVENUE <br /> STOCKTON, CA 95202 <br /> CERTIFICATION OF RETURN TO C014IPLJANCE <br /> For Hazardous Waste Generators <br /> In the matter of the Violation cited on: (, <br /> As Identified in the Inspection Report dated �( <br /> Conducted by: , <br /> l.� [EHD Inspector(s)] <br /> I certify under penalty of law that: <br /> 1. Respondent has corrected the violations specified in the notice of violation cited <br /> above. <br /> 2. I 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 /> individuals who prepared or obtained it, I believe that the information is true, <br /> accurate, and complete. <br /> 4. 1 am authorized to file this certification on behalf of the Respondent. <br /> 5. 1 am aware that there are significant penalties for submitting false information, <br /> including the possibility of fine and imprisonment for knowing violations. <br /> Name(Priv or Type) ITitle <br /> Signature Da Signe <br /> Company Name EPA ID.Number <br /> DTSC-RETCONT.CRT(8194) <br />