Laserfiche WebLink
COUNTY UNIFIERROGRAM AGENCY <br /> aAN JOAQUIN C ,n <br /> 90 <br /> NVIRONMENTAL HEALTH DEPARTMENT <br /> W4 E.WEBER AVENUE W <br /> 3TOCKTON,CA 95202 <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> For Hazardous Waste Generators <br /> In the matter of the Violation cited on: Z [ <br /> As Identified in the Inspection Report dated: 21-72L03 <br /> Conducted by: [EHD Inspector(s)] <br /> 70 <br /> I certify under penalty of law that: <br /> 1, Respondent has corrected the violations specified in the notice of <br /> violation cited above. <br /> 2. l have personally examined any documentation attached to the <br /> certification to establish that the violations 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 of fine and imprisonment for <br /> knowing violations. <br /> Facility Address EPA ID. Number <br /> Name (Print or Type) ytoS Title <br /> Signature Date Signed <br /> EHDCERT(rev 1107102) <br />