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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.sicehd.com/index.html <br /> CONTINUATION FORM Page: of <br /> OFFI IAL INSPECTION REPORT Date: fi�*/7 <br /> Facility Address: �/ Program: 7 <br /> AV <br /> C. <br /> L <br /> (� <br /> G <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 /> EHD 23-02-003 Rev 04/02/14 CONTINUATION FORM <br />