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Cal-EPA DEPARTMENT OF TOXIC SUBSTANCES CONTROL PETE WILSON, Governor <br /> SAN JOAGUIN COUNTY PUBLIC'HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E. WEBER AVENUE / P.O. BOX 388 <br /> STOCKTON, CA 95201-0388 <br /> TIERED PERMITTING <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> For Permit by Rule, Conditionally Authorized, and Conditionally Exempt Notifiers <br /> In the matter of the Violation cited on : <br /> As Identified in the Inspection Report dated <br /> Conducted by : (agency(s)) <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, including the possibility of fine and imprisonment for <br /> knowing violations. <br /> Name (Print or Type) Title <br /> Signature Date Signed <br /> Company Name EPA ID. Number <br /> DTSC-RETCOMP.CRT(8/94) <br />