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.05/16/2018 19:49 5107963470 SHARMA PAGE 04 <br /> ' }#14•x. W Its' <br /> ( t..1- Environmental Health Department <br /> SANJOAQUIN <br /> RECEIVED <br /> MAY r 7 2018 <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> ENVIRONMENTAL <br /> Any MINO violations mated in the"Notice to Compty"in the attached inspection Report must be correc wd O�DEPARTMENT <br /> receipt of this inspection. This certification form must be submitted to the Environmental Health Department(EHD r�si <br /> at the top of this form within 30 clays of receipt of the inspection Report. HSC 25404A.2(c)(1) <br /> All ,QrW0i2ns to other vidatictal noted in the attached Inspection Report(IR)or Continuation Form,or disputes to any <br /> vioiations, are to be submitted using this coMflcation and returned to EI10 within 30 days unless otherwise specified in the <br /> Inspee lon Report. HSC 25185(ex3) <br /> Note: All EMD staff time associated with failing to comply by the above noted dates will be <br /> billed at the current hourly rate. <br /> For this certification to be complete, the operator of the site must include: <br /> A statement documenting what corrective actions were taken or will be takers for each violation <br /> Copies of sample results/manifests/training recordslother appropriate paperwork,and/or photos verifying <br /> oorrections <br /> Operator's certification <br /> Inspection Date; March 12, 2018 Inspected By: AARON HANG <br /> Facility Address-, 1100 S MAIN ST, MANTECA CERS ID: 10182243 <br /> I certify under penalty of law that: <br /> 1. 1 have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br /> and t believe the information to be true,accurate,and complete: <br /> Photos_,Paperwork Statement <br /> 3. 1 am authorized to submit this oertification on tmhalf of the Respondent <br /> 4. 1 am aware that there are significant penalties for submitting false information,including the possibility of a fine <br /> andlor Imprisonment for known violations. (HSC 25191) <br /> Name: Tilde: )LF-'4 5, <br /> Signature:. Date: <br /> 1868 E. Hazelton Avenue I Stockton,California 95205 1 T 209 46"20 F 209 464-0138 1 www,sjoehd.com <br />