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GAI-EPA DEPARTMENT OF TOXIC SUBSTANCES CONTROL PETE WILSON,Governor <br /> SAN JOAQUIN COUNTY PL'reflC HEALTH SERVICES <br /> ENVIRONMENTAL HEALaffi DIVISION Iv/ icon, <br /> 445 N. SAN JOAQUIN STREET I PO BOX 388 LrU <br /> i STOCKTON, CA 95201-0388 <br /> ` JUL 0 5 1995 <br /> t <br /> TIERED PERNIITTING ENVIRONMENT <br /> CERTIFICATION OF RETURN TO COMPLIANCE PERMITMERV <br /> ES <br /> s <br /> For Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers <br /> In the matter of the Violation cited on : May 30, 1995 <br /> As Identified in the Inspection Report dated May 30, 1995 <br /> S <br /> Conducted by : San Joaquin County Public Health Services (agency(s)) <br /> n� vironmen a ea Division <br /> I certify under penalty of law that: <br /> 1. Respondent has corrected the violations specified in the notice of violation <br /> cited above. <br /> 2. I have personally examined any documentation attached to the certification <br /> to establish that the violations have been corrected. <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 /> 5. I am aware that there are significant penalties for submitting false <br /> information. .c'adiz? .� ^ _;_s :, Mit-. .e f fine and imp <br /> knowing violations. <br /> 6. I am requesting a 90 day extension on notice to comply for <br /> Item #11 on the "Checklist and Initial Verification Inspection <br /> Report" . (Outside consultation in progress) <br /> Fnrracr c ' fPnderfer Plant Manager <br /> Name (Print or Type) Title <br /> l9 <br /> <gnature <br /> Date/Signed <br /> Holz Rubber Company, Inc. CAD099952996 <br /> Company Name EPA ID. Number <br /> DISC-R.ETCOMP.CRT(8/94) <br />