Union City, CA · Alameda County
Certification of Return to Compliance
Facilities use this certification to report corrected violations and provide supporting documentation to Union City Environmental Programs.
What this form is
This form certifies that a facility has corrected violations listed in a notice of violation and provides supporting information to Union City Environmental Programs. It applies to violations involving the Clean Water Program, hazardous materials or waste, and underground or aboveground storage tanks. The form asks for facility and inspection details, correction information, required attachments, and an authorized representative’s signature and date.
Who needs it
A respondent authorized to file for a facility uses this certification after correcting violations identified in a notice of violation.
How to submit it
Send the certification and items checked on the form to Union City Environmental Programs, 34009 Alvarado-Niles Rd., Union City, CA 94587. The form notes that photos can be sent by email but gives no email address.
About notarization
This certification is signed and dated without a notary; the signer certifies under penalty of law, and no listed attachment is identified as notarized or sworn.
How to submit this form
- 1
Download the Form
Download the Certification of Return to Compliance for the facility’s cited violations.
- 2
Complete the Certification
Enter the facility and inspection details, describe corrections, and have an authorized representative sign and date it.
- 3
Gather Required Attachments
Include the supporting items checked on the form, such as correction records, a correction letter, or photos.
- 4
Submit to Environmental Programs
Send the certification and checked items to Union City Environmental Programs at the address printed on the form.
Frequently asked questions
- Do I need a notary for the Certification of Return to Compliance?
- No. The certification has a signature and date line but no notary block. It requires the signer to certify under penalty of law; no listed attachment is identified as notarized or sworn.
- How do I submit the Certification of Return to Compliance?
- Send it and the items checked on the form to Union City Environmental Programs at 34009 Alvarado-Niles Rd., Union City, CA 94587. The form says photos can be emailed but does not list an email address.
- What supporting documents does the form request?
- The form lists proof of correction, program-related records, waste disposal records, EPA ID number proof, a letter describing each correction, and photos. Submit the items checked for your case.