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PUBLIC HEALTH SERI CES <br /> SAN JOAQUINCOUNTY = a <br /> JOG[KHANNA N.D.,N.P H. <br /> Healch Officer P <br /> P.O. Box 2009 0 (1601 Eau Hazelton Avenue) 0 Stockton, California 95201 <br /> c4Ci'Fpa�\ <br /> (209) 46&3400 <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> DATE <br /> FACILITY <br /> ADDRESS 45-0 <br /> -o �7t [s �� .3"7` sf f[✓ <br /> OWNER/OPERATOR W � �� T ✓u2 <br /> San Joaquin <br /> !/County Public Health Services-Environmental/Health Division Representatives: <br /> 1, T ✓4e hereby, agree to have all violations per inspection <br /> report(s) dated 5Z271fz pertaining to the above referenced <br /> facility/premises corrected on or before (All reinspection <br /> will be assessed at a rate of $53.00 per hour.) <br /> I further agree that said violations may be detrimental to the public health and/or safety and <br /> will prevent these violations from recurring. I understand that failure to comply with this <br /> agreement will result in further legal remedies and/or may result in the closure of my facility <br /> through suspension or revocation of my Environmental Health Permit. <br /> COMMENTS: 0 Z�ws —luisf'_z'q iwow,�6/" /v[ 3 0 5!& <br /> v <br /> - 7 <br /> Qd'M �[ h �jluw t1t tin �° L ..b.a, // 1793 <br /> Proprietor's S <br /> EH 0042.Gen (Rev 7/2191) <br /> A Dhiti of San Joaquin Co ry F7atrN fire Semon C <br />