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06/14/2007 03:49 2095994265 PAGE 01 I S N JOAQUIN COUN'T'Y ENVIRC,MNIENTAL HEALTH DEPARTMENT 600 East]�Ia-n Street,Stockton,CA 95202-3029 Telephone.(209)468-2,420 Fay (209)468-3433 Web.WWWASigovor ehd I RETURN T COMPLIANCE LIA C CERTIFICATION Any MINOR violations noted in the"NoticdN,to Comply"in the attached inspection report must be - corrected within 30 days of receipt of thi:;inspection. This certification form must be submitted to the Environmental Health Department(F-HD)address at the top of this form within 35 days of receipt of the in report. All corrections to other violations noted �n the attached Inspection Report(IR)or Continuation Form,or disputes to any violations, are to be submitted using this certification and returned to EHD within 60 dans unless otherwise specified in the IR. For this Certification to be cdmplete the operator of the site must include: • A statement documenting what cozhrective actions were taken or will be taken for each violation Copies of sample results/manife;54training records/other appropriate paperwork, and/or photos verifying corrections • Operator's certification Inspection Date: 5 i Inspected By: ray fit. Facility Address: (�( N u.c :eA�,�- ° ® EPA ID#:-CA, I certify under penalty of law that: 1. I have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. 2. I have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION and I belie.-v0 the information to be true, accurate, and complete: .photo Paperwork Statement 3. I am authorized to submit this c ification on behalf of the Respondent. 4. 1 am aware that there are signifi.calnt penalties for submitting false information, including the possibility of a fine and/or imps is�nment for known violations. (HSC 2519 1) i Name: K.V4 Title:_ t Act. lee r Signa re: Date, 1 i EQ 2210AS Rev 69)07