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Environmental Health Department JOAQUIN 01/ SAN ' n 1 � RETURN TO COMPLIANCE CERTIFICATION Any MINOR violations noted in the "Notice to Comply" in the attached Inspection Report must be corrected within 30 days of receipt of this inspection . This certification form must be submitted to the Environmental Health Department ( EHD ) address at the bottom of this form within 30 days of receipt of the Inspection Report , HSC 25404 . 1 . 2 (c)( 1 ) All corrections to other violations noted in 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 30 days unless otherwise specified in the Inspection Report , HSC 25185 (c)(3 ) Note : All EHD staff time associated with failing to comply by the above noted dates will be billed at the current hourly rate . For this certification to be complete , the operator of the site must include : A statement documenting what corrective actions were taken or will be taken for each violation Copies of sample results/manifests/training records/other appropriate paperwork , and/or photos verifying corrections Operator' s certification Inspection Date : June 11 , 2020 Inspected By : JOHN ALANIZ Facility Address : 520 ZEPHYR ST , STOCKTON CERS ID : 10182293 I certify under penalty of law that: 1 . 1 have corrected the violations specified in the Inspection Report from the above- mentioned inspection date, 2 . 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION and I believe the information to be true , accurate , and complete : \ n ^ Photos Paperwork V Statement 3 . I am authorized to submit this certification on behalf of the Respondent. 4 . 1 am aware that there are significant penalties for submitting false information , including the possibility of a fine and/ r imprisonment for known violations . (HSC 25191 ) 1 / Name : Title : Signature • Date : I