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f <br /> • 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.s'cehd.com/index.html <br /> CONTINUATION FORM Page: o�zf� <br /> OFFICIAL INSPECTION REPORT Date: <br /> Facility Address: Program: - tf <br /> 0 i <br /> 3 <br /> 0 <br /> 2 IA <br /> 141 wtgi�� <br /> 0 <br /> o <br /> 'L <br /> 0 <br /> 0�- <br /> l � <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 AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br /> EHD Inspector: Received By: Title: <br /> '5z� <br /> EHD 23-02-003 Rev 04/02/14 CONTINUATION FORM <br />