Laserfiche WebLink
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:www.siaov.org/ehd <br /> CONTINUATION FORM Page: 5 of 5 <br /> OFFICIAL INSPECTION REPORT Date: 06/28/13 <br /> Facility Address: Van de Pol Pacific Pride 351 Beckman Rd. Lodi, CA 95240 Program: HW <br /> SUMMARY OF VIOLATIONS <br /> CLASS I, CLASS II,or MINOR-Notice to Comply) <br /> Complete and submit a copy of the Return to Compliance Certification form with a statement of how <br /> each violation was corrected, including supporting documentation, by July 28, 2013. <br /> Ensure that all required information has been entered into the California Electronic Reporting System. <br /> This completed report supersedes the original checklist issued to the operator during the inspection. <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: Am Received By: Title: <br /> Aris Cacapit (209) 468-3453 <br /> EHD 23-02-003 Rev 04/19/12 CONTINUATION FORM <br />