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PUBLIC *-HEALTH SERN44CES aP4�IN..,C <br /> SAN JOAQUIN COUNTY <br /> r. <br /> ENVIRONMENTAL HEALTH DIVISION e•' < <br /> Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer <br /> 304 E.Weber Ave., 3rd Floor • P. O. Box 388 a Stockton, CA 95201-0388 <br /> 209/468-3420 <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> + <br /> In the matter of the Violation(s) cited on 1 1-13 C( 2 <br /> As Identified in the Inspection Report dated 11-43 _c� 7 <br /> Conducted by S T(! P 44S— EE-F 0 (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. I am aware that there are significant penalties for submitting false information, <br /> including the possibility of fine and imprisonment for knowing violations. <br /> LLUY D RN I, ey Viler 4F F: fn Ks / f1tW#66?' <br /> Name (Print Type) Title <br /> /- 9-7F <br /> Sign a Date Signed <br /> S� r9Lrg-aara & <br /> Company Name EPA ID. Number <br /> A Division of San Joaquin Coanty Health Care Services <br />