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b1/31/2008 11: 44 2049510372 STEPHENS-RIVPT LNDG PAGE 01 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH r1EVARTMENT <br /> 600 Eait Main Street,Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax. (209)468-3433 Web: www.. j ov.ors/chd <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the"Notice to Comply" in the attached Inspection Report must be <br /> corrected within 30 dos of receipt of this inspection. This certification fonn must be submitted to the <br /> Environmental Health Department (EHD) address at the top of this farm within 35 days of receipt of the <br /> Inspection Report. <br /> All corrections to other violations noted in the attached Inspection. Report (IR) or Continuation Form, or <br /> disputes to any violations, are to be submitted using this certification and returned to EHD 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 rioted dates will be billed at <br /> the current hourly rate ($98). <br /> For this certification to be complete the operator of the site must include: <br /> • A statement documenting what corrective actions were taken lir will be taken for ach 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: /�- .36 -- Inspected By: , ✓.sr /ue <br /> Facility Address: 44950 �'ci�e SPA [D : G1t 43aCo7�'SZ _ <br /> I certify under penalty of law that: <br /> I. I have corrected the violations specified in the Inspection Report from the above-mentioned <br /> inspection date. <br /> 2. I have personally examined the following documentation submitted as proof of compliance FOR <br /> EACH VIOLATION and I believe the information to be true, accurate, olid complete: <br /> Photos --Paperwork Statement <br /> 3. lain authorized to submit this certification on behalf of the Respondent. <br /> 4. I am aware that there are significant penalties for submitting false information, including the <br /> possibility of a fine and/or imprisonment for known violations. (HSC 2519 f) <br /> Name: �clrtr.r t�7 \'i .5 Title: rberlS�i`- I <br /> Signatu Date: /-3/ 0 <br /> Pun')')_!7_005 Rev 11/07 <br />