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1 <br /> PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY r` <br /> JOGI KHANNA MD.,MY H <br /> Heaich Officer <br /> P.Q. Box 2009 0 (1601 Fisc Hazelton Awnuc) • Stogy on, Czlifmxia 95201 <br /> (209) 46&3400 <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> DATE — <br /> FACILITY am zk(,,o �Y <br /> ADDRESS <br /> OWNER/OPERATOR f�• �.�/ e <br /> San Joaquin County Public Health Services-Environmental Health Division Representatives: <br /> 1, �_' fig+• k-Fa , hereby, agree to have all violations per inspection <br /> report(s) dated _"'�4�i 2 pertaining to the above referenced <br /> facility/premises corrected on��orr before s:5 u-- ?-6-73 (All reinspections <br /> will be assessed at a rate of X57U 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 /> 75ju '4L",tj 2 -,73 L" 66�-w./1" <br /> Proprietor's Signature <br /> EH 0042.Gen (Rev 7/2./91) <br /> A DMsion o(San Joaquin County Health Clarc 5crr cs <\:> <br />