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PUBLIC HEALTH SExICES <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION <br /> e: F. <br /> Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer4. <br /> 445 N. San Joaquin Street • P.O. Box 388 • Stockton, CA 95201.0388 L«oR <br /> (209) 468-3420 <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> DATE WT <br /> FACILITY 00.,ba (or) C Ckj cf-fz l e,( <br /> ADDRESS 3232 (k)nt- ®o (ZEA.. ftt� <br /> OWNER/OPERATOR <br /> San Joaquin County Public Health Services-Environmental Health Division Representatives: <br /> r <br /> I, hereby, agree to have all violations per inspection <br /> report(s) dated -i4q 1��22 3, 2*5&g !(2Zgpertaining to the above referenced <br /> facility/premises corrected on or before (All reinspection <br /> will be assessed at a rate of$78.00 per hour.) <br /> I further agree that said violations may be detrimental to the public health and/or safety and <br /> will prevent these violations from recurring. I understand that failure to comply with this <br /> agreement will result in further legal remedies and/or may result in the closure of my facility <br /> through suspension or revocation of my Environmental Health Permit. <br /> COMMENTS: A C Q51&rr Dian (,y i I I 1,;r s 0 b r n r-i-'a 40 +V-'`l5 dq`'Cr <br /> fine- LLL s-te n i 1 tank, bL.( Apo 1 30 122E <br /> r <br /> Proprietor's Signature <br /> EH W42-Gen (Rev 8/11/93) <br /> A Di%ision of San Joaquin County Health Care Services <br />