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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0505935
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COMPLIANCE INFO_PRE 2019
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Last modified
3/5/2020 12:04:33 PM
Creation date
3/4/2020 11:25:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0505935
PE
2229
FACILITY_ID
FA0005626
FACILITY_NAME
SANBORN CHEVROLET INC
STREET_NUMBER
1210
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95241
APN
04728013
CURRENT_STATUS
01
SITE_LOCATION
1210 S CHEROKEE LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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RETURN TO COMPLIANCE CERTIFICATION <br /> MAY 1 1 2009 <br /> Any MINOR violat Ions noted in the"Notice to Comply"in the attached Inspecti aftItHEALTH <br /> be corrected within 30 days of receipt of this inspection. This certification form o <br /> ' V4fT/SER KES <br /> submitted to the Environmental Health Department(EHD) address at the top of this form within <br /> 35 days of receipt of the Inspection Report. <br /> All corrections to other violations noted in the attached Inspection Report or Continuation Form, <br /> or disputes to any violations, are to be submitted using this certification and returned to EHD <br /> within 30 days unless otherwise specified in the Inspection Report. <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 ($105). <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 <br /> violation <br /> • Copies of sample results/manifests/training records/other appropriate paperwork, and/or <br /> photos verif ying corrections <br /> • Operator's certification <br /> Inspection Date: -5-08 Inspected By:Aris <br /> Cacapit <br /> Facility Address: 190 Cherkee Ln Lodi CA 95241 EPA ID#:CAD054598289 <br /> I certify under penalty of law that: <br /> 1. I have corrected the violations specified in the Inspection Report from the above- <br /> mentioned inspection date. <br /> 2. I have personally examined the following documentation submitted as proof of <br /> compliance FOR <br /> EACH VIOLATION and I believe the information to be true, accurate, and complete: <br /> Photos Paperwork Statement <br /> 3. I am authorized to submit this certification on behalf of the Respondent. <br /> 4. I am aware that there are significant penalties for submitting false information, including <br /> the <br /> possibility of a fine and/or imprisonment for known violations. (HSC 25191) <br /> Name:Jerry Ct rtis Title:Service <br /> i <br />
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