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ENVIRONMENTAL HEALTH DEPARTMENT <br /> P-1 SAN JOAQUIN COUNTY <br /> 2. I 2 Unit Supervisors <br /> a. Donna K.Heran,RE.H.S. <br /> Director 304 East Weber Avenue, Third Floor Carl Borgman,R.E.H.S. <br /> U): <br /> ,f. . < Mike Huggins,R.E.H.S.,R.D.I. <br /> Al Olsen,R.E.H.S. Stockton, California 95202-2708 Douglas W.Wilson,R.E.H.S. <br /> Program Manager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> Laurie A.Cotulla,R.E.H.S. <br /> Program Manager Fax: (209)464-0138 Robert McClellon,R.E.H.S. <br /> Mark Barcellos,R.E.H.S. <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> DATE: Dec t6 <br /> FACILITY: �1aV w Ie- 122'c:t^�.,L, - "r tAc:- pl"4c- e Tz1�)29Z <br /> ADDRESS: Z 1 �?re i er S ��u.� �o�l<Fo 4f A 175Z-02 <br /> OWNER/OPERATOR: /� ►-, rlGr r �j` �1 e�-�i <br /> SAN JOAQrUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT REPRESENTATIVES: <br /> Cg rr-e�' <br /> I, ,-!�i r y¢r5 ,hereby,agree to have all violation(s)dated No u -Zq OL- <br /> pertaining to the above referenced facility/premises corrected on or before <br /> (All re iii-sreetiom will be 4$93.90 per ). <br /> I further agree that said violations may be determined to the public health and/or safety and will prevent <br /> these violations from recurring. I understand that failure to comply with this agreement will result in <br /> further legal remedies. <br /> COMMENTS: ]�c lam;�s U+ a <br /> T -E-7)y- e--.a G -4-1 r-2_ <br /> f ja X G3 v. E xG n.-n I o- reC¢,o T -122 t 7 <br /> ;Proprietor's Signature <br />