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CONTINUATION FORM Page: of <br /> OFFICIAL INSPECTION REPORT Date: <br /> Facility Address: 06 <br /> (Plaw Program: <br /> *� WIC <br /> SUMMARY OF'VIOLATIONS <br /> ,n^ r (CLASS I, CLASS II, or MINOR-Notice to Comply) <br /> l <br /> m, fk1^J Yu Q S wvz- <br /> r s U [4 <br /> 5 140 1 <br /> nk `�V6�f w -s w"q� <br /> gilt hA <br /> Zx4,-j 2-(02.3y <br /> ►mss <br /> w14_(�G ' 6) 1 " l <br /> All kt�A� <br /> lw k) <br /> nmm f- 4 amass P <br /> 4e <br /> - �u LwP;� l�'1,f✓U�,um � <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE($105). <br /> THIS F CILI Y I SUB ECT TO RE PECTION AT ANY TIME g THE EH CURRENT HOURLY RATE. <br /> EHD Inspector: Received By: Title:;l�& <br /> 4111 <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 EAST MAIN STREET, STOCKTON, CA 95202 <br /> Phone: (209)468-3420 Fax: (209)464-0138 Web www.sjgov.org/ehd <br /> EHD 23-02-003 <br /> REV 09/12//08 CONTINUATION FORM <br />