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SAN 1�J) OAQUIN <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the "Notice to Comply" In the attached inspection Report must be ggrrected within 30 da11A of <br /> receipt of this inspection. This certifloatfon form must be submitted to the Environmental Health Department (EHD) sddrass r <br /> the bottom of this form within 30 days of receipt of the Inapection Report, H80 26404.1 .2(c)(1) <br /> All corrections to ajer violations noted In the attached Inspection report (iRj or Continuation Form, or disputes to any <br /> violations, are to be submitted using this certification and returned to EHO within A d� ave unless otherwise Specified In the <br /> Inspection Report. HSC 26186(c)(3) <br /> Notear All EHD 8ta+ff time associated with failing to comply by the above noted elates will be <br /> billed at the current hourly rate, <br /> For this certification t0 be Complete, the operatarofthe site mustinolude; <br /> A statement documenting what corrective actions were taken or will betaken for each violation <br /> Copies of sample resultsimanifests/training records/other appropriate paperwork, and/or photos vergying corrections <br /> Operator's certification <br /> frtspection Date: . Jtdno 13 , 2019 inspected Bye PAUL USO <br /> Facility Address, 1721S CHEROKEE LN, LODI MRS ID; 10180631 <br /> 1 certify under penalty of law that: <br /> 1a i have corrected the violations specked 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 /> Photos XPaperwork X 5trs#ement <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 . (HSS 20'19;1 } ,_ . <br /> Name; Toni VonRuden Title: Environmental Manager <br /> SIgnat reDate: v� ` <br /> "^ 7.w. <br /> T bi f i : ,�'ai. TH <br /> 1868 C . Naaeltan Avenue i Stockton, California 952051 T 209 468"34201 F 209 464 W <br /> 1 kF 4 , I <br />