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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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14971
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2200 - Hazardous Waste Program
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PR0518530
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COMPLIANCE INFO_PRE 2019
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Last modified
11/20/2024 9:21:33 AM
Creation date
5/31/2019 4:50:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0518530
PE
2220
FACILITY_ID
FA0000540
FACILITY_NAME
COUNTRYSIDE LIQUORS & GAS
STREET_NUMBER
14971
Direction
N
STREET_NAME
STATE ROUTE 88
City
LODI
Zip
95240
APN
06316025
CURRENT_STATUS
01
SITE_LOCATION
14971 N HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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SAN JOAQUIN COUNTY UNIFItD PROGRAM AGENCY R��a�it� <br /> ENVIRONMENTAL HEALTH DEPARTMENT lC ll <br /> ErJ <br /> 304 E.WEBER AVENUE AUG Z()OZ <br /> STOCKTON, CA 95202 1 2 <br /> ENPERMIM SERVICES h <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> For Hazardous Waste Generators <br /> In the matter of the Violation cited on: Z �Z <br /> As Identified in the Inspection Report dated: $ 02 <br /> Conducted by: 6 :i [EHD Inspector(s)] <br /> I certify under penalty of law that: <br /> 1. Respondent has corrected the violations specified in the notice of <br /> violation cited above. r <br /> 2. 1 have personally examined any documentation attached to the <br /> certification to establish that the violations have been corrected. <br /> 3. Based on my examination of the attached documentation and <br /> inquiry of the individuals who prepared or obtained it, I believe that <br /> the information is true, 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 <br /> information, including the possibility of fine and imprisonment for <br /> knowing violations. <br /> -71 �J. �1k-l '6 o u��7Sbc�13 <br /> Facility Address EPA ID. Number <br /> Gp LI f3 oz/o Pres <br /> Name (Print or Type) Title <br /> 6L <br /> Jgn �9 <br /> Signa ure Date Signed <br /> EMCERT(rev 1/07102) <br />
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