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SAN J 0 A Q U I N Environmental Health Department <br /> — COUNTY CONTINUATION FORM <br /> Greatness arnws here. OFFICIAL INSPECTION REPORT <br /> Facility Address: � p � j � � � � � � � Page: _L of� <br /> Date: <br /> Program: <br /> o cru r�� �' 14 /1 C311i <br /> s {rl.(/► // <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 /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcelid.com <br /> EHD 23-02-003 Rev 10/26/17 CONTINUATION FORM <br />