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CONTINUATION FORM of -
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<br /> OFFICIAL L INSP TI N REPORT Date:
<br /> Facility Address: Program: f
<br /> SUMMARY OF VIOLATIONS
<br /> CLASS 1,CLASS 11,or MINOR-Notice to Comply)
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<br /> ALL`EHD STAFF TIME ASSOCIATED YWTH FAi)LING TO tIOMPLY BY THE ABOVE NOTED DATES WILL BE BILLED"AT THE CURRENT HOURLY RATE
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<br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TI,IME AT THE EHD'S CURRENT HOURLY RATE.
<br /> Received By
<br /> EHD Inspector: Title:
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<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 08/12//08 CONTINUATION FORM
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