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OPqu(N• C <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> (209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd <br /> NUISANCE NOTICE TO ABATE <br /> For Unsafe to Health Conditions <br /> FACILITY NAME/TYPE: . LICENSE: DATE: <br /> ,*-Nr �� z� Iy <br /> ADDRESS: � CITY:COO// ZIP COD9:�13Z /fiWy �Z Celt, rr <br /> ❑VEHICLE OWNER ❑PROPERTY OWNER ❑TENANT: `r TELEPHONE#: <br /> 'v'rl <br /> TYPE OF INSPECTION: OMPLAINT ❑OTHER PROGRAM ELEMENT: RECORD <br /> I D#: <br /> NATURE OF COMPLAINT/VIOLATION: _ <br /> QCq')Pi e:0 7N <br /> UNSAFE HEALTH CONDITIONS OBSERVED: ❑ FIRST NOTICE ❑ FINAL NOTICE <br /> ❑ Unsanitary Conditions <br /> ❑ Lack of Sanitation Facilities (toilet, hand wash, bathing facilities) <br /> ❑ Lack of Adequate Garbage Facilities <br /> ❑ Lack of Potable Water Supply <br /> ❑ Unsafe Fuel Supplied Equipment (fuel supplied heater/stove/generator-sources of carbon monoxide) <br /> ❑ Fire Hazard (unsafe use of candles, space heater, extension cords, camp fire, stoves) <br /> Occupancy of tents, campers, vehicles outside of an appropriately permitted park (special occupancy <br /> park, labor camp, campground/resort, organized camp) <br /> ❑ Other: <br /> VIOLATIONS: SJC Ordinance Code, Section 8-5100-It is a violation of this division for any property owner to permit <br /> or maintain a nuisance on his property. California Civil Code, Section 3479-Anything which is injurious to health is a <br /> nuisance. <br /> CORRECTIVE ACTIONS/ORDERS: <br /> EFFECTIVE IMMEDIATELY- <br /> Xcease unpermitted occupancy outside of approved park. <br /> ❑ Disconnect and/or cease use of all hazardous and/or unsanitary connections. <br /> ❑ HAZARDOUS CONDITIONS EXIST— UNSAFE TO OCCUPY—VACATE IMMEDIATELY <br /> ALL EHD STAFF TIME ASSOCIATED WITH RESOLVING THIS COMPLAINT WILL BE BILLED AT THE CURRENT HOURLY RATE 5) <br /> 13�,vo <br /> COMPLIANCE RECHECK IN ❑ 24 HOURS X <br /> 48 HOURS ❑ 10 DAYS <br /> FAILURE TO COMPLY WITH THIS NOTICE <br /> MpRy RESULT IN FORMAL ENFORCEMENT ACTION <br /> Donna Heran, REHS,rDDi/IVirector <br /> /4 <br /> INSPECTED BY: J "ll <br /> PHONE: <br /> SIGNATURE OF REGISTE It <br /> D E RONMENTAL HEALTH SPECIALIST <br /> rw l DATE: <br /> RECEIVED BY: SIGNATURE OF OWNER/TENANT <br /> EHD 13-29 5/2/12 Nuisance Notice to Abate <br />