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SU0006865 SSCRPT
Environmental Health - Public
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SU0006865 SSCRPT
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Last modified
5/7/2020 11:32:45 AM
Creation date
9/4/2019 6:07:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSCRPT
RECORD_ID
SU0006865
PE
2622
FACILITY_NAME
PA-0700565
STREET_NUMBER
13282
Direction
S
STREET_NAME
ESCALON BELLOTA
STREET_TYPE
RD
City
ESCALON
APN
20720009
ENTERED_DATE
12/12/2007 12:00:00 AM
SITE_LOCATION
13282 S ESCALON BELLOTA RD
RECEIVED_DATE
12/11/2007 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\E\ESCALON BELLOTA\13282\PA-0700565\SU0006865\SSC RPT.PDF
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EHD - Public
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F.SAN J'OAQUIN COUNTY UNIFIL., PROGRAM AGENCY M A (I <br /> ENVIRONMENTAL HEALTH DEPARTMENT T;• , S J ` /�(/� <br /> �S04 E.WEBER AVENUE <br /> TOCKTON, CA 95202 <br /> 03 OCT 10 PM 1: 03 )0� <br /> F <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> For Hazardous azardous Waste Generators <br /> 1 <br /> � <br /> FIn the matter of the Violation cited on: q2c5b� <br /> As Identified in the Inspection Report dated: Z� <br /> �� <br /> Conducted by: � (�hTy j [EHD Inspector(s)] <br /> k <br /> I certify under penalty of law that: <br /> i <br /> F <br /> 1. Respondent has corrected the violations specified in the notice of <br /> violation cited above. <br /> �a <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 /> F!� 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 /> jr M.evI-e►,) TAL . <br /> Facility Address EPA ID. Number <br /> ?E�T IE <br /> F' N7,;, <br /> rint or Type) Title <br /> 1 <br /> 7 <br /> Signature Date Sig ed <br /> j EHDCERT(rev 1107102) <br />
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