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PUBLI 1EALTH SERVtES �ut� <br /> SAN JOAQUIN COUNTY <br /> EIN VIRONMENTAL HEALTH Di ISION <br /> Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer <br /> 304 E.Weber A e., 3rd Floor • P. O. Box 388 * Stockton, CA 95201-0388 c, �'. <br /> 209/468-3420 <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> In the matter of the iolation(s) cited on <br /> As Identified in the I spection Report dated /P 9� <br /> Conducted by ( ,�; _ E�LT�-�E/Ie6L_L_(agency or agencies) <br /> I certify under penalty of law that: <br /> 1. Respondent has corrected the violations specified in the notice of violation cited <br /> above. <br /> 2. 1 have perso ally examined any documentation attached to the certification to <br /> establish that a violations have been corrected. <br /> 3. Based on my. examination of the attached documentation and inquiry of the <br /> individuals w o prepared or obtained it, I believe that the information is true, <br /> accurate, and complete. <br /> 4. 1 am authorized to file this certification on behalf of the Respondent. <br /> 5. 1 am aware at there are significant penalties for submitting false information, <br /> including the ossibility of fine and imprisonment for knowing violations. <br /> L , Lr2P/ c.--- " � <br /> Name (Print or Type) Title <br /> S' ature Date Signed <br /> Company Name EPA ID. Number <br /> A Division or San Joaquin County Health Care Services <br />