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'PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY ' <br /> jOGI KHANNA;vf.D.,M.P H. <br /> Health Officer <br /> P.Q. Box 2009 • (16601 East Hazelton Avenue) • Stockton, C'-11if[rrnia 9520E <br /> (209) 468-3400 <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> DATE <br /> FACILITY `f' a2VS <br /> ADDRESS a l a y� S• lv� 3 3 <br /> OWNER/OPERATOR . 'L lA/k4e <br /> San Joaquin County Public Health Services-Environmental Health Division Representatives: <br /> I, 40tt.; +k-Qe , hereby, agree to have all violations per inspection <br /> report(s) dated pertaining to the above referenced <br /> facility/premises corrected onorr before 1-G� � �-�-� ?-6-Y3 . (All reinspections <br /> will be assessed at a rate of per hour.) <br /> I further agree that said violations may be detrimental to the public health and/or safety and <br /> will prevent these violations from recurring. I understand that failure to comply with this <br /> agreement will result in further legal remedies and/or may result in the closure of my facility <br /> through suspension or revocation of my Environmental Health Permit. <br /> -- COMMENTS: <br /> 5/. d'o'a� 70z 2 <br /> Proprietor's ignature <br /> EH 0042.Gen (Rev 7R_491) <br />