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44 -u <br /> SAN OQ JUN 0 3 2019 Envpvonmer rrroiga Clea 114h OepaiiLF4TLICc) rrLL <br /> - COUNTY- A <br /> Greatness growsEE qv]'RONMENTAL HEALTH <br /> "ART � , , <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 <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 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 EHD within 30 days unless otherwise specified in the <br /> Inspection Report , HSC 25185 (c) (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 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 <br /> corrections <br /> Operator' s certification <br /> Inspection Date : May 16 , 2019 Inspected By : CLAUDIA MURO <br /> Facility Address : 17707 E HWY 26 , LINDEN CERS ID : 10182341 <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 /> Photos X Paperwork X Statement <br /> 3 . 1 am authorized to submit this certification on behalf of the Respondent. <br /> 4. I am aware that there are significant penalties for submitting false information , including the possibility of a fine <br /> and/or imprisonment for known violations. ( HSC 25191 ) <br /> Name : Paula S 1Urviance Title : Corporate Secretary <br /> Signa Date : 6 / 3 / 19 <br /> ( <br /> 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468-3420 F 209 464-0138 1 www. sjcehd . com <br />