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From:PAUL OIL 0 <br /> 209 847 9726 08/0010 13:38 4441 P. 001/010 <br /> PAUL OIL Fax:2098923935 Aug 9 201 1343 P.01 <br /> SAN JOAQUIN COUNTY <br /> ENviRONM6NTAL HEALTH DEPARTMENT - <br /> 600&.Main St.,Stockton,CA 95202-3029 <br /> Telephone.(209)468-3420 Fax:(209)468-3433 Web:2LN .sj ov.or eh <br /> RETURN TO COMPLIANCE CERTIFICATION,,,, UG U 1010 <br /> Any MINOR violations noted in the"Notice to Comply"in the attached Inspection RepoftiCiiust be.' -;AL <br /> corrected within 30 dans of receipt of this inspection. This certification form must be submitted to the"ENT <br /> Environmental Health Department(EHD) address at the top of this form within 35 days of receipt of the <br /> Inspection Report. <br /> All corrections to other violations noted in the attached inspection Report or Continuation Form,or <br /> disputes to any violations,are to be submitted using this certification and returned to EBD within 30 days <br /> unless otherwise specified in the Inspection Report. <br /> Note: All EHD staff time associated with failing to comply by the above noted dates will be billed at <br /> the current hourly rate ($105). <br /> For tl'l1S certification t0 be complete the operator of the site must include: <br /> • A statement documenting what corrective actions were taken or will be taken for each violation <br /> • Copies of sample results/manifests/training records/other appropriate paperwork,and/or photos <br /> verifying corrections <br /> • Operator's certification <br /> Inspection Date: ?- at . t a Inspected By:ffk4 - nv�Yt. —�- <br /> Facility Address: ;2�td G a S• Set. 14_ Qe) EPA ID#: <br /> I certify under penalty of law that: <br /> 1. I have corrected the violations specified is 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_,L_Statemeut <br /> 3. I am authorized to submit this certification on behalf of the Respondent. <br /> 4. I am aware that there are significant penalties for submitting Use information,including the <br /> possibility of a fine and/or imprisonment for known violations. (HSC 25191) <br /> Name:_ 9;93 �-wro" Title: yp Signature: Date: %,-t . t o <br /> RM 22-02-005 Rev 10-07 <br />