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SANJOAOUINEnvironmentalHealthDepartmentCOUNTY”Crc’growsher’,RETURNTOCOMPLIANCECERTIFICATIONAnyMINORviolationsnotedintheNoticetoComply”intheattachedInspectionReportmustbecorrectedwithin30daysofreceiptofthisinspection.ThiscertificationformmustbesubmittedtotheEnvironmentalHealthDepartmentfEHD)addressatthebottomofthisformwithin30daysofreceiptoftheInspectionReport.HSC25404.1.2(c)(1)AllcorrectionstootherviolationsnotedintheattachedInspectionReportfIR)orContinuationForm,ordisputestoanyviolations,aretobesubmittedusingthiscertificationandreturnedtoEHDwithin30daysunlessotherwisespecifiedintheInspectionReport.HSC25185(c)(3)Note:AllEHDstafftimeassociatedwithfailingtocomplybytheabovenoteddateswillbebilledatthecurrenthourlyrate.Forthiscertificationtobecomplete,theoperatorofthesitemustinclude:Astatementdocumentingwhatcorrectiveactionsweretakenorwillbetakenforeachviolation•Copiesofsampleresults/manifests/trainingrecords/otherappropriatepaperwork,and/orphotosverifyingcorrections•Operator’scertificationInspectionDate:June14,2024InspectedBy:HAZASAEEDFacilityAddress:4900EMariposaRd,StocktonCERSID:10184585Icertifyunderpenaltyoflawthat:1.IhavecorrectedtheviolationsspecifiedintheInspectionReportfromtheabove-mentionedinspectiondate.2.IhavepersonallyexaminedthefollowingdocumentationsubmittedasproofofcomplianceFOREACHVIOLATIONandIbelievetheinformationtobetrue,accurate,andcomplete:_______Photos_______PaperworkStatement3.IamauthorizedtosubmitthiscertificationonbehalfoftheRespondent.4.Iamawarethattherearesignificantpenaltiesforsubmittingfalseinformation,includingthepossibilityofafineand/orimprisonmentforknowItions.fHSC25191)Name:LTitle:CobcSignature:Date:I