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;AN JOAQUIN COUNTY UNIFI•WGRAM AGENCY N <br />NVIRONMENTAL HEALTH DIVISION <br />04 E. WEBER AVENUE <br />,TOCKTON, CA 95202 <br />CERTIFICATION OF RETURN TO COMPLIANCE <br />For Hazardous Waste Generators <br />In the matter of the Violation cited on: 12, lP -gI 1) <br />As Identified in the Inspection Report dated <br />Conducted by : <br />I certify under penalty of law that: <br />Inspector(s)] <br />1. Respondent has corrected the violations specified in the notice of violation cited <br />above. <br />2. I 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. I 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 />Name (Print or Type) Title <br />Si ture Date Signed <br />C�e�l v�S i 1�rtaa�L�v, CAu-)op (gu-r 4 <br />Company Name �C1ZS EPA ID. Number <br />DTSC-RETCOMP.CRT (8/99) <br />