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S A I J O Q U I N Environmental Health Department <br /> COUNITY <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violatlons noted in the'Nolice 10 Comply"to the atiached Inspection Report must be correctea within 3,0 days of <br /> receipt of this inspection This cert&cahon form rnust be submrtled to the Environmental health Department(E HO)adOress at <br /> the bottom of 111is form within 30 days of receipt of Iha rnspecl ion Report HSC 25404.1.7{c)(1) <br /> All orrecliGns lo.olher violalrons noted in the 8tlZche*d Inspection Raporl(IR)or Continuation Form, ar disputes to any <br /> violalions,are to be submitted using th:s uerhficattan and returned to EH within 34 dais,unless ClKerwise specified rn the <br /> Inspection Report. HSC 251M(c)(3) <br /> Note: All EHD staff fiMe asSoelated with fairing to comply by the above noted dates will be <br /> billed at the current hourly rate_ <br /> For th is cerdfl atlon to be complete, the operator of the site must include, <br /> A statement documenting what correclive aclions were la ken ocwiIII be Laken for each violal ion <br /> Copies of Sample resultsl+nanilestsltreining recwdslother appropriate paperwork, andlai pholos verifying rorrecuons <br /> Operator's cerlification <br /> Inspection Date: July 08, 2025 Inspected By: LYNSEY SAMMONS <br /> Facility Address: 1877 Indusinal Or, Stockton CERS ID: 10186783 <br /> 1 certify under penalty of law that. <br /> 1 1 have corrected the v+to"-ations specified in the Ermpection Report from the above-mentioned irispection dale. <br /> 2 I grave personally examine#lire follow mg documantation submitted as proof of corinp3i ance FOR EACH VIOLATION <br /> ana I believe the information to 7ae true, accu(ate, and complete: <br /> x Phalos —Paperwork x Statement <br /> 3. 1 am aulhorized to submit Ihis certification on behalf or the Respondent <br /> d 1 am aware that Ihere are S!gniftcanl penalties Ior sobmilling fa'5e information. iric+uoir!g the possibility of a fine andfor <br /> imprr5onment for known violation5 iH 25191) <br /> dame. Daniel Bell Title; Maintenance Supervisof <br /> Signature_� �� —Date --La/-3J2-5 <br />