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08/07/2019 09:02 209-836-2584 FEDEX OFFICE 1469 PAGE 02 <br />RECEIVE® <br />s SANJOA01JIN AUG 0 7 2019 Environmental Health Department <br />Greatness grows herc,ENVIRONMENTAL HEALTH <br />PERMITISERVICES <br />RETURN TO COMPLIANCE CERTIFICATION <br />Any MINOR violations noted in the "Notice M Comply' in the attached Inspection Report must be comachad within 30 days of <br />receipt ofthls inspection. This ceNfication form must be submitted to the Environmental Health Department (EHD) address at <br />the bottom of this form within 30 days of receipt of the Inspection Report_ HSC 25404.1.2(c)(1) <br />All corrections to other violations noted in the attached Inspection Report (iR) or Continuation Form, or disputes to any <br />violations, are to be submitted using this certification and returned to EM within 30 days unless otherwise specified in the <br />Inspection Report, HSC 25185(c)(3) <br />Note: All EHD staff time associated with failing to comply by the above noted dates wdl be <br />billed at the current hourly rate. <br />For this certification to be complete, the operator of the site must include <br />A statement documenting what corrective actions were taken or will be taken for each violation <br />Copies of sample resulodmanifestsmaining recordslother appropriate paperwork, and/or photos venlying corrections <br />Operators certification <br />Inspection Date: July 23, 2019 Inspected By: CESAR RUVALCABA <br />Facility Address: 17000 LOWER JONES RD, STOCKTON CERS ID: 10484881 <br />I certify under penalty of law that: <br />1. 1 have corrected the violations specified in the Inspection Report from the atwva-mentioned inspection dale, <br />2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION and <br />I believe the information to be true, accurate, and complete: <br />_Photos—Paperwork x Statement <br />3. 1 am authorized to submit this certification an hehalf of the Respondent <br />4. 1 am aware Nat there are significant penalties for submitting false Information, including the possibility of a fine and/or <br />imprisonment for known violations. (HSC 25191) <br />Name: -C-'4") 1 l7 (JCC_T Title: />25S` / 4aw /-6a..a�e <br />a <br />$ 0iolA4ia#J iwR 0010k/ {-r/.Ez C*,)44,w.2 Sia sflees L'o"-4eW a 3o ym/.�JJ <br />Tl/NA4C Co ihRWr�h A,Nrmc w, YY, "Ak�Na/u1sarpo;i,e-ka."5-Ar�x <br />slew AC'NMd/A'Ifv✓ $.4o¢.iCfFk Sir•cKtR, <br />1856 E. Hazelton Avenue I Stockton, California 952051 T 209 46834201 F 209 464-0138 i www.sjcehd.00m <br />Received' Time Ar- 7. 2019 9:VAM No, 5349, <br />