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SAN,JOAQUIN <br />COUNTY <br />Greatness grows here. <br />Environmental Health Department <br />CONTINUATION FORM <br />OFFICIAL INSPECTION REPORT <br />Facility Address: <br />Wo <br />?RCI <br />Page: —!-of <br />Date: j�3�z�lg' <br />Program: <br />A04'ell <br />K '1'0- � &L* s <br />.` e <br />cam.,. > .� o� <br />lse <br />4w w / <br />CCD <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 <br />AT ANY TIME AT EHD'S CURRENT HOURLY RATE. <br />EHD Inspector: <br />Received By: <br />Title: <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 <br />www.sjcehd.com <br />EHD 23-02-003 Rev 10/26/17 CONTINUATION FORM <br />