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Environmental h Department <br /> SAN JOAQUIN <br /> _ TURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the " Notice to Comply" in the attached Inspection Report must be corrected within 30 days of <br /> receipt of this inspection. This certification form must be submitted to the Environmental Health Department ( EHD) address <br /> at the top 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 EHD within 30 days unless otherwise specified in the <br /> InspectionReport, HSC 25185(c)(3) <br /> Mote : All EHD staff time associated with failing to comply by the above rioted dates will 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 ghat corrective actions were takers or will be taken for each violation <br /> Copies of sample results/manifests/training records/other appropriate paperwork, and/or photos verifying <br /> corrections <br /> Operator's certification <br /> Inspection Date : September 12 , 2018 Inspected ray . TRICIA DAI <br /> Facility Address : 811 ZEPHYR ST. STOCKTON CERS ID * 10186901 <br /> I certify under penalty of law that <br /> 1 . I have corrected the violations specified in the Inspection Report from the above -mentioned inspection date. <br /> 2, I have personally examined the follovring documentation submitted as proof of compliance FOR EACH VIOLATION <br /> and I believe the information to be true , accurate , and complete: <br /> Photos Paperwork Statement <br /> 3. I am authorized to submit this certification can behalf of the Respondent <br /> 4. I am aware that there are significant penalties for submitting false information , including the possibility of a fine <br /> and/or imprisonment for known violations, '(HSC 25101 ) <br /> Marne : Title : . t <br /> Signature : ' 717, Date : t <br /> 1868 E . Hazelton Avenue l Stockton , California 95205 1 T 209 488-3420 l F 209 464-01133 114v#rw.sjcehd corn <br />