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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.secehd.com/index.html <br /> CONTINUATION FORM Page: _— of <br /> OFFICIAL INSPECTION REPORT Date: <br /> Facility Address: 13 %1 `.Q-1 11-Wit)4 1(- 14 tki ELS 3� Program: <br /> to L b� L>rJ �T�RLa.E0 <br /> I <br /> i <br /> I <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 EEHD'S CURRENT HOURLY RATE. <br /> EHD Inspector: �61- Received By: Title: <br /> Ul�k)Qs� <br /> EHD 23-02-003 Rev 04/02/14 CONTINUATION FORM <br />