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PUBLIC tEALTH SER CES <br /> SAN JOAQUIN COUNTY <br /> I*: < <br /> ENVIRONMENTAL HEALTH DIVISION <br /> Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer <br /> ��FpR <br /> 445 N. San Joaquin Street • P.O. Box 388 • Stockton, CA 95201-0388 <br /> (209) 468-3420 <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> DATE A 0 2 <br /> FACILITY E")4agVa o lamas i-�v;t^�s <br /> ADDRESS L 1 2tab <br /> OWNER/OPERATOR <br /> San Joaquin County Public Health Services-Environmental Health Division Representatives: <br /> I, 1ae_X hereby, agree to have all violations per inspection <br /> reports) dated pertaining to the above referenced <br /> facility/premises corrected on or before . (All reinspection <br /> ,W 87,— <br /> will be assessed at a rate of $R.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: -1.0 N �-, a .Q -�4� ►:fit <br /> S ` -� ; ,•oil <br /> IeL— <br /> Prop!��gSignature <br /> EH 0042-Gen (Rev 8/11/93) <br /> A Division of San Joaquin County Health Care Services <br />