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PUBLIC HEALTH SERVICES ,o'ch �a <br /> SAN JOAQUIN COUNTY r: <br /> N: S <br /> JOGI KHANNA M.D.,M.P.H. <br /> Health Officer <br /> C. P <br /> P.O. Box 2009 . (1601 Last Hazelton Avenue) . Stockton,California 95201 <br /> (209) 468-3400 <br /> nn ADMINISTRATIVE HEARING AGREEMENT <br /> h-1 <br /> DATE U6Us-f a 1 19$5 <br /> FACILITY I R M Ow l\ Ui ALM)T r�20(t)E '& <br /> OWNER/OPERATOR hIA1-t01vb WALQUT L-Qn1)F91i <br /> PUBLIC HEALTH SERVICES OF SAN JOAQUIN COUNTY, ENVIRONMENTAL HEALTH <br /> DIVISION REPRESENTATIVES IWO U-)IsoU - gopprvls tnf QHS <br /> A I G P4ViLA S h I + NS <br /> I, f r�i � �HmticL hereby, agree to have all violations per <br /> reams) dated 7-/7- 9 pertaining to the above referenced <br /> establishment corrected on or before a mss„ 4" 2, <br /> I further agree that said violations may be detrimental to the public health and/or safety and will <br /> prevent these violations from recurring. Failure to comply with this agreement will result in further <br /> legal remedies. �J <br /> SIGNED BY PROPRIETOR X <br /> LJ �'/•� U l cC� c!/ct� a�,ro v-P�-Q �uti-„.;/ezu� u-��-rn-1 a�i� �/� �`�t � ,� <br /> /c�ahtiQ Lu iat�.w.. So u'..•-y” 1. �OU�w,�a-u'r 2�/(%�9 �!� °U!� CG�&�-- <br /> �e vt e a- L✓o u e- O�Ct l�5n (� ,��Lw� 5-0 Ct2&Y'o C/Uo ot-U, zc-) 2/ /1 d 5' ) <br /> Sic Wcc rf r!t0'ohC000v A7`� � Yij�-+hhmn-ss,te+.�✓l/'P'rlq l6�'IVcSGas.. GL.w�-Q <br /> A Division of San Joaquin County Health Care Services <br />