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N JOAQUIN LOCAL HEALTH DISTRICT - <br /> BOARD OF TRUSTE! 1601 Fast man Avenue <br /> James Culb*Aeon. Pi Ptom 46"791a <br /> ' <br /> Patacia E. Vannuml. STOCKTON. CALIFORNIAR. <br /> mgoA i CiOW11yA. <br /> Anlhonea to Van Spro+ Xgaf E.atot+ ._ ^ <br /> Emi rNnanla! vitae Maftitf <br /> INSPECTION' REPORT <br /> Forn DUO** city of Rlpott <br /> oanhf L. F1or.e ny of Stodctoet <br /> Joan 0. Mast. IA.D. '; Owner/ ator� ate—J � 19_ CIt of Yr <br /> Oyer � / y <br /> W1111afn J.Wada maquin Count]► " "� <br /> aAary Anna {.ow I.ocati saquln County <br /> i J B <br /> Facility NaG- <br /> Address <br /> 0D U I ►� <br /> [late of In _ ' t m e4nr-d Ltrr• <br /> I <br /> MON ITORT -� 6' l�-thl C, <br /> h � r <br /> Anna V id a $M e Go v��5 <br /> wily. tom...- ' b' -egarding <br /> compl e <br /> Pi , lid <br /> 5 <br /> Datly <br /> - / a <br /> y cal i b <br /> Implementa :CLED items <br /> be comps et <br /> Precis tted to <br /> this a <br /> 2. P i pel i Received Notice: <br /> 03- Dally )OGI KHANNALRe <br /> D., MPH, District Health Officer maintained <br /> at the W <br /> gi Sani rian <br /> 4bl� <br /> Docume , EH 00 20 - I - <br /> 7/85 <br /> ti.,_.__ ----- --- - -' --- - -- <br /> Submit quarterly statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates and variatiops that <br /> exceeded allowable.* The first statement is sue by <br /> C6) Dispenser. meters) must be calibrated by -21 —,2?—,9'7 with copy of <br /> certification or Weights and Measures sticker number submitted to this office. <br /> If the above compliance dates cannot be met. contact this office prior to the specified <br /> -date- <br /> If <br /> ate_If allowable daily inventory variation is exceeded. refer to Section 2644(f) for <br /> required actions. <br /> -3-86 UGT 1 <br />