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PUBLICtEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer <br />445 N. San Joaquin Street • P.O. Box 388 • Stockton, CA 95201-0388 <br />(209) 468-3420 <br />ADMINISTRATIVE HEARING AGREEMENT <br />DATE VZ 2Q 1q4 <br />w"'IMMUMOR5 led <br />,9JLM OrUMQ <br />San Joaquin County Public Health Services -Environmental Health Division Representatives: <br />T. <br />I, _s2M„_ r1 acd n . hereby, agree to have all violations per inspection <br />report(s) dated- q /T 3�3o/Q� pertaining to the above referenced <br />facility/premises corrected on or before1� q JOA- . (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 violation 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 />CONE%4ENTS: <br />/►w� is L _ . I :► • �] ► • i f 1� t ■WAKE. ' <br />EH 0042.Gen (Rev 8/11/93) <br />A Di%ision of San Joaquin County Health Care Services <br />iolc j E�6 <br />