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$ANJOAQUI COUNTY UNIFIED PROGRAM AGENCY <br />LINIVIRONIVIE AL HEALTH OF-PAFTMENT <br />304 E. WEBER A ENUE <br />$TO 0 KTO N, CA 5202 <br />CERTIFICATION OF RETURNT I QSO <br />Far Hazardous Waste Gen e-,-ai6rs. <br />In thEl matter of the Violati:)n cited on; <br />As Idjentifiedin the Inspection Report dated: <br />Conducted by.—Jim Pqcaic _[EHD Inspector(s)] <br />I certify under penalty of 4aw that: <br />1 Respondent I ias corrected the violatio is specified in the notice of <br />violation cited above. <br />2. 1 have persor ally examined any docurr. entation attached to the <br />certification 1 o establish that the violations have been corrected. <br />3. Based on my exam ; ination of the a <br />ttac ed documer <br />r` •' <br />and <br />inquiry of the individuals who prepared or obtained It, I believe"that <br />the information is true, accurate, and ryomplete. <br />4. 1 am authorizi W to fife this certffication on behalf of the Respondent. <br />5. I am aware tt at there are significant p -nalties for submitting false <br />information, including the possibility o -'fine and imprisonmentfor <br />knowing violittions. <br />Facility Address' p EPIC 113; Number <br />A4 <br />Name (Print or Typ a) TRIO <br />o <br />Signature Dato Signied <br />EMOCORT (r*V 1107102) <br />60 39Vd NH NOdWVG GT9LT9V606 9V:S0 V66T/66/T0 <br />