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2200 - Hazardous Waste Program
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PR0514326
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COMPLIANCE INFO
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Last modified
6/30/2020 10:43:50 AM
Creation date
6/23/2020 6:25:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0514326
PE
2220
FACILITY_ID
FA0000514
FACILITY_NAME
MAIN STREET SHELL*
STREET_NUMBER
1071
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21707011
CURRENT_STATUS
02
SITE_LOCATION
1071 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\HW\HW_2220_PR0514326_1071 N MAIN_.tif
Tags
EHD - Public
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10 <br />3AN JOAQUIN LOUNTY UNIFIEC&OGRAM AGENCY <br />NVIRONrkNTAL HEALTH DIVISION <br />304 E. WEBER AVENUE <br />3TOCKTON, CA 95202 <br />CERTIFICATION OF RETURN TO COMPLIANCE <br />For Hazardous Waste Generators <br />In the matter of the Violation cited on: <br />As Identified in the Inspection Report dated 'Y 3 �M .1 <br />Conducted by : ALLSON1 y0LkJ4 BL002 R -E -H' S _ [EHD Inspector(s)J <br />I certify under penalty of law that: <br />1. Respondent has corrected the violations specified in the notice of violation cited <br />above. <br />2. I have personally examined any documentation attached to the certification to <br />establish that the Violations have been corrected. <br />3. Based on my examination of the attached documentation and inquiry of the <br />individuals who prepared or obtained it, I believe that the information is true, <br />accurate, and complete. <br />4. I am authorized to file this certification on behalf of the Respondent. <br />5. I am aware that there are significant penalties for submitting false information, <br />including the possibility of fine and imprisonment for knowing violations. <br />N HOT PL� PAIJ/-V6?F-P\ <br />Name (Print or Type) Title <br />Signature Date Signed <br />MAI j i hEl-L-- <br />Company Name <br />DTSC-RETCOMP.CRT (8/99) <br />CA L_ 0 0 0 0 2 65--4 1 <br />EPA ID. Number <br />
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