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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: http://www.s6cehd.com/index.html <br />CONTINUATION FORM <br />OFFICIAL INSPECTION REPORT <br />Page: C of c <br />Date: X21 r(z k <br />Facility Address: p a 5 -„�,, _ <br />Program: 4 Z—> <br />y1 <br />a� <br />6 6 <br />� <br />� J <br />8 ' 'I- L v <br />r <br />_ vi <br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT <br />THE CURRENT HOURLY RATE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD Inspector: <br />AAIIJ� <br />Received By: <br />Title: <br />SR R <br />V <br />EHD 23-02-003 Rev 04/02/14 CONTINUATION FORM <br />