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08-30-1996 08:39AM FROM TO 7273017 P.07 <br /> PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY �a �d •..� <br /> ENVIRONMENTAL HEAL`FWOILVIS191NI 3 'X <br /> Ernest M. Fujimoto, M.D., M.P.H., Acting Health Ofiicer <br /> 304 E.Weber Ave., 3rd floor o P. O. Box 388 t Stockton, CA 9$201-0388 <br /> 209/468-3420 <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> In the matter of the Violation(s) cited on 3aG 95- <br /> As Identified in the Inspection Report dated S o6 9 5— <br /> Conducted <br /> Conducted by L—/P/c' Ti➢, y—rAJA , TITLF A&.-Nc Y ,4 vE_ (agency or agencies) <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. 1 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 /> V' llea r/E� �ay�.L�9.r/GE �Pr�d/so.P <br /> Name (Print or Type) Title <br /> Signature 13to Si ned <br /> Company Name EPA ID. Number <br /> i <br /> A Division of San Joaquin County Health Cart Serviees <br />