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SAN 10AQUIN <br />COUNTY <br />Greatness grows here. <br />Environmental Health Department <br />CONTINUATION FORM <br />OFFICIAL INSPECTION REPORT <br />Facility Address: <br />t5;e_1 hrJe <br />Page: i of <br />Date: <br />Program: <br />121017 mar Z, r . d <br />2 <br />r ; <br />fey e-1-4. t la- te. ,wr r�PP <br />`-n s c <<d Jr-! J 7r r_ �t o -s- f" � c5'G� � C / w �R <br />d�cl -��.5 Cl: s • � `! '' <br />if / / f <br />'^ <br />c'tl���«�'�i�,� <br />•- ��p aJr s -* fl <<A-".�c 4,t4 <br />f I <br />1 I� L�� <br />^. <br />�L I y <br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE <br />BILLED AT THE CURRENT HOURLY RATE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S <br />CURRENT HOURLY RATE. <br />EHD Inspector: <br />Received By: <br />Title: <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 <br />www.sjcehd.com <br />EHD 23-02-003 Rev 10/26/17 CONTINUATION FORM <br />