Laserfiche WebLink
pF l and Donna Parks 20VJ95410 <br />SAN ENVIRONMENTAL IOUNTY HEALTH DEPARTMENT <br />PROGRAM AGENCY <br />DEPARTMENT <br />304 E. WEBER AVENUE <br />STOCKTON,CA 95202 <br />ERTIFICATION dF RETURN TO COMPLIANCE <br />C <br />For Hazardous Waste Generators <br />In the matter of the Violation cited on: <br />t'f ed in the Inspection Report dated: _ <br />s�° 5 <br />P.1 <br />As Iden � � <br />�� _f1��___,_[EHD Inspector(s)] <br />Conducted by: A <br />certify under penalty of law that: <br />I. Respondent has corrected the violations specified in the notice of <br />violation cited above. <br />tion attached to the <br />2 1 have certification t lestabl sexam1h that the violationned any s have been corrected. <br />3, Based on my examination of the attached documentation and <br />inquiry of the individuals who prepared or obtained it, I believe that <br />the information is true, 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 <br />information, including the possibility offine and imprisonmentfor <br />knowing violations. <br />a,e"n t� gIC'Vz <br />Facility Address <br />EPA ID. Number <br />C <br />OY1 r�UV f 01 <br />-- Title <br />Name (Print or Type <br />lam/ __j" a� <br />A)L� — Date Signed <br />Signature <br />EHDCERT (rev 1107102) <br />