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SAN JOAQUIN Environmental <br /> E�E `�IEDnt <br /> LIAR 2 5 2025 <br /> RETURN TO COMPLIANCE C El TIFICATI RONMENTAL HEALTH <br /> PERMITI ERVI E <br /> Any M[NOR violations noted rn the"Notice to Comply' in the at d mw Inspection Report must be corrected within 30 dove of <br /> receipt of this inspection This cerlifiicakm form must be submitted to the Environmental Health Department(FHD)address at <br /> the bWrn of this farm within 30 days of receipt of the inspact,on Report HSC 75404.1.2(c)(1} <br /> All corrections to other violations noted in the attached Inspection Report(IR)or ContinuaGaro Form,or disputes to any <br /> violations. arti to be submitted using this certification and returned to 1=Hd 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 atthe current hourly rate. <br /> For this CeTtifiGation to be complete, the operator of the site must inoude <br /> A statement documenbng what corrective ecteons were taken of val I W taken for each viofation <br /> Copies of sample resuttslmanifestsnrairang nacwrdsromer appropriate paperwork,andfor photos vanfyrng Corrections <br /> Operator's certifacatwn <br /> Inspection Date: February 28. 2025 Inspected By: KRI TINA SAIETERN <br /> Facility Address; 20177 S MA ARTHUR DR, TRA Y CERS 1D: 10182595 <br /> 1 certify under penalty of iaw that <br /> t I have corrected the viofatiom 8padited in the Inspectwn Report from the above`menUaned inspection Cate <br /> 2 t have personally examined the fo3tpwrng document0on sut rmitted as proof of compliance FOR EACH VIOIATIGN <br /> and I believe the information to be true,accurate,and complete: <br /> Z Phms X Paperwork Y Statement <br /> 3 1 am authorized to submit this certifiCalion on behaif of the Rospondent- <br /> 4 l am aware that there are signiLGant penattr9s For submitting Nise informat►on. including the possibrlrty of a fine andfor <br /> imprisonment for known violations. (HSC 25191) <br /> Name: •e o ` �e. Title: ur. <br /> Signature: Date-, 6z � . . <br />