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Environmental Aer6lMjrntment <br /> RJOANIN <br /> —COUNTY— ED <br /> AUG 'a' 0 2018 <br /> RETURN TO COMPLIANCE CERTIFICATION ENVIRONMENTAL <br /> l� L] <br /> Any MINO violations noted in the Notice to Comply"in the attached inspection Report must be corrected HwitAhin 0AfRTAAENT <br /> receipt of this inspection, This certification form must be submitted to the Environmental Health Department(EHD)address <br /> at the top of this form within 30 days of receipt of the inspection Report. HSC 25404.1.2(c)(1) <br /> All corrections tg=r violations noted in the attached Inspection Report(IR)Qr Continuation Form,or disputes to any <br /> violations,are to be submitted using this certification and returned to EHD within 30 d2ya unless otherwise specified in the <br /> Inspection Report. HSC 25I85(o)(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 to be cioMpleite," ft operator of the site must in' c'lude: <br /> A statement documenting what corrective actions were taken or will be taken for each violation <br /> Copies of sample results/manifests/train ing records/other appropriate paperwork, and/or photos verifying <br /> corrections <br /> Operator's certification <br /> Inspect'on Date: _.August 02, 2018 inspected By: ZUNABARKER <br /> Facility Address: 1700 E YOSEMITE AVE, MANTECA CERS ID: 10181431 <br /> I certify under penalty of law that: <br /> 1. I have corrected the violations specified in the Inspection Report from the above-mentioned inspection date, <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br /> and I believe the information to be true,accurate,and complete: <br /> JF Photos Paperwork--4/-Statement <br /> 3. I 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 possibility of a fine <br /> and/or imprisonment for known violations. (MSC 25191) <br /> Name: 00_ r t.c Title: 'ec I <br /> Signature <br /> 1868 E.Hazelton Avenue I Stockton,California 952051 T 209 468-3-4201 F 209 464-0138 1 www.sjoehd.com <br />