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B <br /> SANJOAQUIN Environmental Health Department <br /> ---•COUNTY-- <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the"Notice to Comply"in the attached Inspection Report must be corrected within 30 days of <br /> receipt of this Inspection. This certification form must be submitted to the Environmental Health Department(EHD)address at • <br /> the bottom of this form within 30 days of receipt of the Inspection Report. HSC 25404.1.2(c)(1) <br /> All corrections to other violations noted In the attached Inspection Report(IR)or Continuation Form,or disputes to any <br /> violations,are to be submitted using this certification and returned to EHO within 30 days unless otherwise specified in the <br /> Inspection Report. HSC 25185(c)(3) <br /> Note: All EHD staff time a..,ciated with failing to comply by the above noted dates will be billed <br /> at the current hourly rate. <br /> For this certification to be complete, the operator of the site must include: <br /> A statement documenting what corrective actions were taken or will be taken for each violation <br /> Copies of sample results/manifests/training records/other appropriate paperwork,and/or photos verifying corrections <br /> Operator's certification <br /> Inspection Date: June 15,2020 Inspected By: JOHN ALANIZ <br /> Facility Address: 1501 W Charter Way,Stockton CERS ID: 10706107 <br /> Fende r penalty of law that: <br /> ve corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br /> ve personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br /> I believe the information to be true,accurate,and complete: <br /> Photos Paperwork Statement <br /> authorized to submit this certification on behalf of the Respondent. <br /> aware that there are significant penalties for submitting false information,including the possibility of a fine <br /> r imprisonment for known violations. (HSC 25191) <br /> +R`7f 1pr9--C it Title:e:�� Date:—113 5�0 5t, <br /> t <br />