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SAN 1 OAQ U I N Environmental Health Department <br /> ------COUNT Y <br /> -` ._ �ffi..(17f'{4 fii:i rr"•. i�7PrF'. <br /> RETURN 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 /> Inspection Report. HSC 25185(c)(3) <br /> Note: All EHD staff time associated with failing to comply by the above noted dates will be <br /> billed at the current hourly rate. <br /> 1I or this u—&- ifICatiOi 1 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 results/manifests/training records/other appropriate paperwork, and/or photos verifying <br /> corrections <br /> Operator's certification <br /> Inspection Date: November 30, 2018 Inspected By: TRICIA DAI <br /> Facility Address: 4071 N WILSON WAY, STOCKTON CERS ID: 0 <br /> 1 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. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br /> and I believe the information to be true, accurate, and complete: <br /> L"'-Photos_L/Paperwork Statement <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. <br /> 4. 1 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 25191) <br /> Name: f t � ii of v Title: <br /> Signature: Date: 1Z� /�r <br /> Valley . Sales <br /> Buy Here Pay Here RECEIVED <br /> Greg Barrows & MAX .IAN 0 2 2019 <br /> Finance and Sales Manager. PR Mgr ENVIRONMENTAL HEALTH <br /> 4071 N WILSON WAY PERMIT/SERVICES <br /> STOCKTON <br /> Cell 209 481-2697 Office 209 546-7827 Fax 209 943-0101 <br /> gregvalleyauto@yahoo.com <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com <br />