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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: htto://www.sicehd.com/index.html <br />CONTINUATION FORM <br />OFFICIAL INSPECTION REPORT <br />Page: of <br />Date: '-'1 al 0 I i -7 <br />Program: Facility Address: 0 wiLiS) 6, ki f r ,y2) ri.:1 ,-s <br />d•F ,,-/e4,4: Iss-P6 <br />12T--- II 3 r.,-- el <br />-t? .5.-A 12.-c- - ( z-4,--e <br />Itc Sc.,y-r_e-vi <br />'Lc - vt 3 c "."-A _ <br />k 3 - 1 o A 1¼.ec-- C 4..LniS <br />k761 - S,,,c1=-4-4- <br />lict bo.e,s 04' kvt . LI, P.rt ( a...A ce,v-e,v‘ot-N- A--te_ lk,k ,......2„cof <br />- Iglu* 3--ov-ct.o,, Le......).-s <br />- G. C -4,1,--- <br />rei ve, t. ..- 542.- 7 1 '--5-7 civov't <br />— t....,,x-f- syl.e - i V- IS" . „A, <br />4 i 14119 (Q,,n Es &Air) <br />--101-ii 040 ',Jell ," Well s' AS -lik tNtiofi'l ‘25 "it - <br />g70 — 4701% S c-vt!eiAl kiS - itb 41 ' 'S NAcnp <br />L <br />i-LO -‘ -}- 3 L., <br />'j- C-94 .oa,"-.4 -11-S417. 5A <br />Pei — -31Alf(Act:'fo-t,v+ <br />,Ay-f-Ate, 0.1., SA-e- (a_- <br />Le. -gf- s v4-4- p 7 tO 2. 2- Air Net), bA cA.k) \ 0 1.2-S14.m <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 />EHD Inspector: Received By: Title: <br />CONTINUATION FORM <br />EHD 23-02-003 Rev 04/02/14