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;aI-EPA DEPARTMENT OF TOXIC SUBSTANCES CONTROL PETE ULSON, Guvwnw <br /> SAN JOAQUIN COUNTY PUBLIC :ALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E. WESER AVENUE I P.O. BOX 388 ''"E <br /> STOCKTON, CA 99201-0388 n <br /> TIERED PE:R11417TING <br /> CWFITICATION QF REUM TO C'OIVIPI.IANCl <br /> For Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifies <br /> In the matter of the Violation cited on : 30 MAY '95 <br /> As Identified in the Inspection Report dated 30 MAY 195, ITEM 11 <br /> Conducted by : San Joaquin Cnty. Public Health Services (ageney(s)) <br /> Lnvironmental Health Division <br /> I certify under penalty of law that: <br /> 1.1 Respondent has corrected the violations specified in the notice of violation <br /> cited above. <br /> 2. I have personalty examined any documentation attached to the certification <br /> ito establish that the violations have been corrected. <br /> I <br /> 3. Based on my examination of the attached documentation and inquiry of <br /> the individuals who prepared or obtained it, I believe that the information <br /> is true, accurate, and complete. <br /> 4. I am authorized to file this certification on behalf of the Respondent. <br /> S. I am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment for <br /> knowing violations. <br /> TED E. COOPER ENGR. MANAGER <br /> Name (Print or Type) Title <br /> Sj�ature Date Signed <br /> HOLZ RUBBER COMPANY, INC. CAD 099952996 <br /> C -pang Name EPA ID. Number <br /> VT -R9TC0W.CRT i8f9�) <br /> TOTAL P.03 <br />