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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, Cal'rfomia 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 web:www.sogov.org/e <br /> CONTINUATION FORM Page: 2 of 2 <br /> OFFICIAL INSPECTION PO T Date: 2/19/2012 <br /> Facility Address: 775 Second St., Stockton CA 95206 Pro ram: HM <br /> SUMMARY OF VIOLATIONS <br /> CLASS I,CLASS II,or MINOR-Notice to ComPly) <br /> A Return to Compliance form, a blank Chemical Description Page form with instructions, a blank <br /> Annotated Site Map form with instructions, a CERS flyer and a Lead User Authorization form <br /> provided at the time of inspection. <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> Title: <br /> EHD Inspector: <br /> Received By: <br /> CONTINUATION FORM <br /> EHD23-02-003 Re04/19112 <br />