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2015-07-27 13:59 FUEL QM IVERY 12092347295 >> 2094683433 P 2/5 <br />San Joaquin County <br />Environmental Health Department <br />n fec E <br />E I VE L, <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Tolophonei: (209) 468-3420 Fox. (209) 468-3433 Web: wov,Qrgj� <br />JUL 2 7 20i5 <br />RETURN TO COMPLIANCE CERTIFICATION 117NIVIRONMENTAI <br />-711 <br />Any MQB violations noted in the "Notice to Comply" in the attached inspection Report must be ggrregted_within ZQ gpyk of <br />receipt of this inspection. This certification form must be submitted to the Environmental Health Department (EHO) address <br />the top of this form within 30 days of receipt of the Inspection Report. HSC 25404,1,2(c)(1) <br />All corrections tg 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 END wjtbjLZQ_dM 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 corrections <br />InspectionDate: <br />June25,2015 <br />Inspected By:- <br />ARIS VELOSO <br />Facility Address: <br />351 N BECKMAN RQ, LODI <br />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 2) Paperwork 1Statement <br />3, 1 am authorized to submit this certification on behalf of the Respondent <br />4. 1 am aware that there are significant penalties for submitting false information, including the possibility of a fine a <br />imprisonment for known violations. (HSC25191) <br />I <br />