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BOARD OF TRUSTEES S4) JOAQUIN LOCAL HEALTH DIS*CT SERVING <br /> Jwmm C411wrison,PM& City of Lodi <br /> Mary An"EAW10,VIM Pr" 1601 East Hazelton Avenue,P.O.Box 2009 San Joaquin County <br /> Patricia L Vannuccl,S*c'y. San Joaquin County <br /> Tommy Joyce Stockton,Calftomia 95201 CRY of Escalon <br /> Earl Pkn*nW City of Manteca <br /> vkvwa Mad"We (209)466-6781 City of Ripon <br /> Do"L Flores City of Stockton <br /> John D.Ma i%OLD. Jo9I Khanna,MA,M.PA.,Dkirld Health Ofter City of Tracy <br /> San Joaquin County <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> DATE <br /> FACILITY /0 1A ile, 3 c,C, C) <br /> MO 6A, <br /> k' " N <br /> OWNER/OPERATOR <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT REPRESENTATIVES i-A-i,44jrs- Co 444 Ila, <br /> hereby, agree to have all violations <br /> per inspection report(s ) dated pertaining <br /> to the above referenced establishment corrected on or before <br /> I further agree that said violations may be detrimental to the <br /> public health and/or safety and will prevent these violations from <br /> recurring . Failure to comply with this agreement will result in <br /> further legal remedies . <br /> SIGNED BY PROPRIETOR <br />