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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 /> OFFICIAL INSPECTION REPORT Date: <br /> Facility Address: 1..`��i`l l c �� 0.5205 Program: 3oQ <br /> 5 o <br /> VK"S C'� <br /> \n F �c o �C ll� -- <br /> p� Ac f - <br /> \ tit 'A2 1-p bag �\ <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: 7i� <br /> sJ Vv � <br /> CONTINUATION FORM <br /> EHD 23-02-003 Rev 04/02/14 <br />