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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: http://www.secehd.com/index.html <br />• • '•' <br />Date: <br />I LSI ♦ Oy /�...L! ��/MOO i -/_�� i/ • , / , <br />"--MEW �I/ <br />� � Irl :lv�• � � [1 'i .� /. [1 � • �f'.�.:,/ <br />If 3WR AA WA .�✓!J <br />q.7lwd1 <br />i <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 . . <br />EHD 23-02-003 Rev 04/02/14 CONTINUATION FORM <br />