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San Joaquin County <br /> Environmental Health Department <br /> 1 WS East Hazefton Avenue,Stockton,California 95205.6232 <br /> Ti►1 •(209)468-3420 Fax,(209)468.3433 Web.W",a!2w_oWkbd <br /> RETURN TO COMPLIANCE I CERTIFICATION <br /> Any MIN violations noted in "Notice to Comply"in the attached Inspection Report must be ►NMIDLOM'Of <br /> receipt of this ins n. This certification farm must be submitted to the Environmental Health Department(EHD)address <br /> the tap of this form within 30 days of receipt of the Inspection Report HSG 25404.1.2(c)(1) <br /> All congggaLW other vjQlatic> 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 r=HD w-bia 30 daya unless otherwise specified in the <br /> Inspection Deport HSC 25185(c)(3) <br /> All EHD sniff time associated with failing to comply by the above noted dates will be <br /> billed at the current hourly <br /> For this certification to be Complete, the operator of the site must include: <br /> A staWment documenting what corrective actions were taken or will be taken for each violation <br /> Copies of sample results/manifests/training recordslother appropriate paperworK and/or photos verifying corrections <br /> inspection Date: June 25, 2015 inspected : ARIS VELOSO <br /> Facility Address. 25651 N HWY 99. ACANiPQ 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 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 and! <br /> imprisonment for known violations. (HSC 25191) <br /> Name: `'`4 Ff itie: <br /> ante: <br /> Signature: <br /> VE( " <br /> hL 17:NV RONMENTAL <br /> 2015 <br /> _wine Yt,r�aua � . PIS" <br /> 5000/Z000 all00 ISN RTCOCCC609 YVd KdZZ:ZT STOZ/LT/LO <br />