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SAN 10 A Q U f N Environmental Health Department <br /> COUNTY CONTINUATION FORM <br /> crFd�N Greatness grows here. OFFICIAL INSPECTION REPORT <br /> Facility Address: Page: of <br /> o i Date: p7(y l_a' <br /> Program: <br /> ce, ( ►tier k s <br /> 0 0 � �.� C<� dam` U-ri► J i�f��/.��0 <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 /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br /> EHD 23-02-003 Rev 10/26/17 CONTINUATION FORM <br />