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San Joaquin County DIRECTOR <br /> Environmental Health Department Donna Heran,REHS <br /> •OG ASSISTANT DIRECTOR <br /> Q••' 600 East Main Street Laurie Cotulla,REHS <br /> Stockton, California 95202-3029 PROGRAM COORDINATORS <br /> e• :a <br /> Mike Huggins,REHS, RDI <br /> C, p Margaret Lagorio,REHS <br /> qciFpRc�\ Website: www.sjgov.org/ehd Robert McClellon,REHS <br /> Phone: (209)468-3420 Jeff Carruesco,REHS,RDI <br /> Fax: (209)464-0138 Kasey Foley, REHS <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> DATE: <br /> FACILITY: 1100j6- pno c '� <br /> ADDRESS: �` ZS ;'►/ f"� �G��.1K--Yt1+� , r CA-Aa <br /> OWNER/OPERATOR: <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT REPRESENTATIVES: <br /> 044- <br /> I, �� , hereby, agree to have all violation(s)dated <br /> pertaining to the above referenced facility/premises corrected on or before <br /> (All re-inspections will be assessed at a rate of$105.00 per hour). <br /> I further agree that said violations may be determined to the public health and/or safety and will prevent <br /> these violations from recurring. I understand that failure to comply with this agreement will result in <br /> further legal remedies. <br /> COMMENTS: <br /> 7 , <br /> Pro or's Signature <br /> PUBLIC/UNITVI/UNITVIFORMS/ADMINISTRATIVEHEARINGAGREEMENT <br />