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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue , Stockton , California 95205-6232 <br /> Telephone: (209 ) 468- 3420 Fax: (209 ) 468-3433 Web :.http : //www . s a cehd . com/index . html <br /> 5111- <br /> 1 n,� aP ,CONTINUATION FORM Page , of <br /> OFFICIAL INSPECTION REPORT Date : v r / /G `2 o z <br /> j <br /> acility Address : Ass0CI i rCiL k, or StaVI � JA L Program : Usr /J <br /> c, cvr t,,� W .r> j Ck4w"ti 0 0 is <br /> SUMMARY OF VIOLATIONS yyJJ <br /> (CLASS I , CLASS II , or MINOR= Notice to Comply) <br /> i <br /> ry NN <br /> sIv <br /> \Op <br /> I <br /> I <br /> 1 <br /> r � % <br /> r <br /> Q <br /> IN <br /> IN <br /> 1 <br /> IF <br /> ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE. <br /> THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD ' S CURRENT HOURLY RATE , <br /> E Inspector: Received By: Title: <br /> Va ,t , . I <br /> EHD 23-02-003 Rev 04/02/14 CONTINUATION FORM <br />