Laserfiche WebLink
7to! <br />Rfr- <br />or <br />RPM <br />ff tune associated with failing to comply try thr: o nt dates .vii/ be <br />this certification to fie.�camplete�� �. <br />a statement oc ;'q en*Un 'T aces wets tak+ n of be tact ' f :. <br />Uopies of sample resuits n�anifes t idstot + r ap i is i i p, t tom a ttf t t01 <br />corrections <br />„ Operator's certification <br />Janus 11, 2016 �v <br />Inspection Date: January Inspected By: <br />Facility Address: 1097 YOSEMITE AVE CERS ID: 1 e <br />certify under penalty of law that} <br />1. I have corrected the violations specified in the Inspection Repo" W rom thea <br />2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOL. <br />and I believe the information to be true, accurate, and complete: <br />Photos Paperwork V/1 Statement <br />3_ i arra authorized to submit this certification on behalf of the Respondent. <br />4, 1 arm aware that there are significant penalties for submitting false information, including the possibility of a fire <br />and/or imprisonment for known violations. (NSC 25191) <br />Name: 1f i1 Title: <br />nature. <br />_ Date: %/ <br />