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SAN 10AQUIN <br />COUNTY <br />Cr eatness grows here. <br />Environmental Health Department <br />CONTINUATION FORM <br />OFFICIAL INSPECTION REPORT <br />Facility Address: <br />,� Q Q � <br />�t <br />�� ��� <br />Page: � of I <br />Date: <br />Program: <br />k <br />n J L �t u�- <br />01tv0V <br />r,o <br />S&, -J 11A meet, L/ <br />!� I.w �•.� <br />4 o 4 <br />iQA <br />ina <br />Carl <br />o► Tn,,y j 4 <br />S L4 <br />e'v.i 1,14 (e <br />Q <br />14- s <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 FACILI Y IS SUBJECT TO REINSPECTION AT ANY TIME <br />AT EHD'S 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 />