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PUBLIC'OfEALTH SERMCES a�,N <br /> SAN JOAQUIN COUNTY ?° .c <br /> NVIRONMENTAL HEALTH DIVISION <br /> Ernest 1 . Fujimoto, M.D., M.P.H., Acting Health Officer _. <br /> 304 E.Weber Ave., 3rd Floor • P. O. Box 388 • Stockton, CA 95201-0388 �: : '9 • �q� NSP <br /> 209/468-3420 F O R <br /> ERTIFICATION OF RETURN TO COMPLIANCE <br /> In the matter of the Violation(s) cited on <br /> As Identified in the Inspection Report dated <br /> Conducted by _ ,�. Z< i'� Z ,7/—J,,L' (-,, (agency or agencies) <br /> I certify under pen Ity of law that: <br /> 1. Respondent has corrected the violations specified in the notice of violation cited <br /> above. <br /> 2. I have pers nally examined any documentation attached to the certification to <br /> establish tha the violations have been corrected. <br /> 3. Based on y examination of the attached documentation and inquiry of the <br /> individuals ho prepared or obtained it, I believe that the information is true, <br /> accurate, an complete. <br /> 4. 1 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 /> G A-) <br /> Name (Print or Type) Title <br /> � -77 <br /> S' ature Date Signed <br /> Company Name EPA ID. Number <br /> A Division of San Joaquin County Health Care Services <br />