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08-02-07 04:17pm From-TAIT ENVIROMEENTAL 714-560-8237 T-338 P.04/06 F-937 <br /> 0 <br /> w- <br /> ' SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,SwCktOn,CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.aiSpy,o nhd <br /> RETURN TO I CERTIFICATION <br /> Any MINOR violations noted in the"Notice to Comply"in the aftched inspection report must be <br /> corrected within 30 days of receipt of this inspection, This certification form must be submitted to the <br /> Environmental Health Department(END)address at the top of this form within 35 days of receipt of the <br /> inspectiaareport. 'Permit application was submitted on 7/13/2007 . <br /> An MRP will be sent: to you when the work is complete <br /> All corrections to other violations noted in the attached Inspection Report(IR)or Continuation Form, or <br /> disputes to any violations,are to be submitted using this certification and returned to EHD within 60 days <br /> unless otherwise specified in the IR. <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 <br /> verifying corrections <br /> • Operator's certification <br /> Inspection ate: Inspected By: <br /> Facility Address:-90 7 I i.ncoln Road, Stockton EPA #: <br /> I certify under penalty of law that: <br /> I. I have corrected the violations specified in the Inspection Report from the above-mentioned <br /> inspection date. <br /> 2. I have personally examined the following documentation submitted as proof of compliance FOR <br /> EACH VIOLATION and I believe the information to be true, accurate,and Tete: <br /> Photos PaperworkStatement <br /> 3, I am authorized to submit this certification on behalf of the Respondent. <br /> 4. I am aware that there arc significant penalties for submitting false information,including the <br /> possibility of fine and/or imprisonment for known violations.(HSC 25191) <br /> P <br /> N Title: rw'aL«owCe <br /> Signature: r Date: �® <br /> EHD 22-02-005 Rev 05/07 <br />