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03/02/2012 03:38 9252920074 GDF_SOLUTIONS FAX PAGE 01/15 <br />SAKI JOAQIXM COUNTY <br />ENVIRommi=NNTAL HEALTH DEPARTMENT <br />Q0o Fast Mach fleet, Stodkton, CA 96202-3029 <br />T*Wm&: (209) 468-3420 F[t (209) 46$-3+133Web : vMWsiaov.wWehd <br />liq r11111111111111111ir <br />Any MIM violletions noted in the "Notice to Comply° in the aided Inspection Report must be <br />within 30 days of reosipt of this- i . -Mit font must ba' Submitted to tt a <br />r-wironmentai Health Departnert (EHO) address at the top of this form w oln 30 of receipt of the <br />Inspection Report. He(; 25404.1.2 G 1) <br />AU— aiher vhdlatiDrtB nowl in the allsched Inspection_ Report (IR) or Continuation Fo m, or <br />disputes .o any vl of be subrruttsd using this certifiGabort and returned to EHD within 30 dans <br />unless in the I " RBailin Sto25eomPIY by tila� abate rtoWd dates will be <br />Note: All EHD 'dme a 9 <br />Filled at the current hourly rate. <br />For this certification tv e Con:L)6te the operator of the site must include: <br />. Astatementdocumenting what corrective acwere taken or will be taken fer each violates <br />• Conies of sarricle MuMmmifteWbaining rewn9s/other appropriate paperwork, ander photos <br />Iris on tie: January 30, 2012 <br />Ins BY:Garrett Backus <br />Facility Act :2575 Country Club EPA IID#: <br />I haw ConveW Me violations Specified in the InSPOWOn Report *Qm the above�4�loned <br />imWectiondate. <br />- <br />Photos G <br />3. 1 am authorized to submit this certification on behalf of the Respondent. <br />4. 1 am aware that there are significant penafts for submitting false information, including the <br />.i" a fine andior i MOA for known vk*diom- (HSC 2519/1) <br />n tete lldC!` Tittr3 otil -r G+l R t <br />E#VXWftVX M' <br />10 3DVd ISS 960OZ666OZ 96:6Z ZI6Zi6Z/10 <br />