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0 0 <br />SAN JOAQUIN COUNTY REGEIVED <br />EWIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, California 95265-6232 JUL 3 1 2014 <br />ratephone: (209) 468-3420 Rx, (209) 468.3433 Web: MW.slooyorg/ehd <br />ENVIRONMENTAL <br />e� . �• � W,�• _ .� • - : _ � ..- gym•• .� <br />71 11jF <br />Inspection Report. HSC 25404.1.2(o)(1) <br />unless otherwise specified in the Inspection Report. HSC 25185(c)(3) <br />Note: All EHD staff time associated with failing to comply by the above noteddates will be <br />billed at the current hourly <br />verifying,For this certification to beCOMPWO 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 appropdate paperwork, and/or photos <br />corrections <br />Operatoescartification <br />Inspection Date: June 30, 2014 1 Inspected syArls Veloso --J1 <br />W -177r, Ira ARM <br />I certify under penalty of law that: <br />--!a-photos Paperwork <br />3. 1 am authorized to submit this certification on behalf of the Respondent. <br />4. 1 am aware that tilers are significant penalties for submitting false information, including the <br />possibility of a fine and/or imprisonment for known violations, (HSC 25191) <br />END 22-w-006 RGV 04149112 <br />ZO'd Vq:ZL VLOZ 16 InP OL6L99b60Z:xe3 10d 30 NVA <br />