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� 4 <br /> SAN JOAQUIN COUNTY <br /> -DIA ENVIRONMENTAL HEALTH DEPARTMEN <br /> J1 1868 East Hazelton Avenue, Stockton,California 232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web: w,.org/ehd <br /> RETURN TO COMPLIANCE CFO��IFICX�b*14 <br /> ARG <br /> Any MINOR violations noted in the "Notice to Comply"in the attached I 00*V401f <br /> 1 rt must be <br /> corrected within 30 days of receipt of this inspection. This certification fro�Tte <br /> Environmental Health Department(EHD) address at the top of this form within 30 the <br /> Inspection Report. HSC 25404.1.2(c)(1) <br /> All corrections to other violations noted in the attached Inspection Report(IR)or Continuation Form, or <br /> disputes to any violations, are to be submitted using this certification and returned to EHD within 30 days <br /> unless otherwise specified in the Inspection Report. HSC 25185(c)(3) <br /> Note: All EHD 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 t0 be Complete the operator of the site must include: <br /> • A statement documenting what corrective actions were taken or will be taken for each violation <br /> • Copies of sample results/manifests/training records/other appropriate paperwork, and/or photos <br /> verifying corrections <br /> • Operator's certification <br /> Inspection Date: May 14, 2014 Inspected By:Stacy Rivera <br /> Facility Address:3505 Navy Dr., Stockton EPA ID##: CAL000334428 <br /> I certify under penalty of law that: <br /> 1. 1 have corrected the violations specified in the Inspection Report from the above-mentioned <br /> inspection date. <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR <br /> EACH VIOLATION and I believe the information to be true, accurate,and complete: <br /> Photos Paperwork ''l Statement <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. <br /> 4. 1 am aware that there are significant penalties for submitting false information, including the <br /> possibility of a fine and/or imprisonment for known violations. (HSC 25191) <br /> Name:_Stephan Rosen _ _ Tltle: Senior HSE Manager--West Region <br /> Signature: �. 1 -3 e` `^ Date: 30 May 2014 <br /> EHD 22-02-005 Rev 04/19/12 <br />