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ENVIRONMENTAL HEALTH DEPARTMENT <br /> PQM," SAN JOAQUIN COUNTY <br /> z � Unit Supervisors <br /> Q ?� Donna K. E.H.S. <br /> Director R 304 East Weber Avenue, Third Floor Carl Borgman,R.E.H.S. <br /> Al Olsen,R.E.H.S. Stockton, California 95202-2708 Mike Huggins,R.E.H.S.,R.D.I. <br /> . ` Douglas W.Wilson,R.E.H.S. <br /> oq� R��c Program Manager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> r-0Laurie A.Cotulla,R.E.H.S. Robert McClellon,R.E.H.S. <br /> Program Manager Fax: (209) 464-0138 <br /> Mark Barcellos,R.E.H.S. <br /> ADMINISTRATIVE HEARING AGGREMENT <br /> DATE 5Zz 6 Z <br /> FACILITY r // <br /> ADDRESS 17/00 <br /> OWNER/OPERATOR /`mor C�ioS� <br /> San Joaquin County Environmental Health Department Representatives: <br /> hereby, agree to have all violations per inspection <br /> report(s) dated pertaining to the above referenced <br /> facility/premises corrected ��r before -��� �M-,V- (All re-inspections <br /> will be assessed at a rate of ssx100 per hour). <br /> I further agree that said violations may be determined to the public health and/or safety and will <br /> prevent these violations from recurring. I understand that failure to comply with this agreement <br /> will result in further legal remedies and/or may result in the closure of my facility through <br /> suspension or revocation of my Environmental Health Permit. <br /> COMMENTS: ;''��zar.� �v��� t �,/,� 4•� f <br /> �t�.•�7���yyff�i -letcf S. �rc���g T/tom s� <br /> i' 4- wL sir /atiz"i'ze1 ls� eGi t�or'j'1 f S <br /> 1001, <br /> j�•�.�. ,C��ih�� � Grimm l <br /> Proprietor's Signature <br /> EH 0042.GEN(REV 6/11/02) <br /> 1 <br />