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Mar 28 16 03:41 p p,1 <br /> San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 MAR 2 8 2016 1 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.sjgov.o[g1ehd <br /> N A <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 /> the top of this form within 30 days of receipt of the Inspection Report. HSC 25404.1,2(c)(1) <br /> All gogrrections,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/manifestsftraining recordslother appropriate paperwork, and/or photos verifying corrections <br /> Inspection Date: March 21, 2016 Inspected By. FATINAH ZAREEF <br /> Facility Address: 7906 N EL DORADO ST, STOCKTON EPA ID. <br /> I certify under penalty of law that: <br /> 1. 1 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 /> I believe the information to be true,accurate, and complete: <br /> Photos Paperwork Statement <br /> 3. 1 am authorized to submit this certification onbehalf of the Respondent. <br /> 4. 1 am aware that there are significant penalties for submitting false information, including the possibility of a fine anclic <br /> imprisonment for known violations. (HSC 25191) <br /> in <br /> Name: V'k k L4 YN Tdle: &2AAD-n e-Y <br /> Signature: Date: <br /> 4r- <br />