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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, California 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209) 468-3433 Web:www.sigov.org/ehd/unitiii.html <br /> CONTINUATION FORM Page: 5 of 5 <br /> OFFICIAL INSPECTION REPORT Date: 12/17/10 <br /> Facility Address: 166 Frank West Cir., Stockton Program: APSA <br /> SUMMARY OF VIOLATIONS <br /> CLASS I, CLASS II,or MINOR-Notice to Comply) <br /> Complete & submit a copy of the Return to Compliance Certification to the EHD by January,!�, 2011 <br /> along with any supporting paperwork and a statement documenting the corrective actions that have <br /> been or will be taken for each violation. <br /> Provided: <br /> - Return to Compliance Certification form <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE($122). <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT END'S CURRENT HOURLY RATE. <br /> EHD Inspector. Rece�v 'By: Title: <br /> J <br /> EHD 23-02- <br /> 3 v 08/10/10 CONTINUATION FORM <br />