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ult <br />`1°,, SANsd0AQUIN <br />! COUNTY <br />Greatness qrows �Ipe <br />-Pj2%6338 Environmental Health Department <br />f CONTINUATION FORM <br />�1'Yll'>Ilu TQi�if1 L�l2 OFFICIAL INSPECTION REPORT <br />Facility Address: <br />12M <br />05ti ki <br />Page: of <br />1 Date: <br />Progr <br />FOR <br />.11111iffill, MG1111110A.. <br />Off <br />AM 01 <br />me' 11u a <br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING O COMPLY BY THE ABOVEDATES 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 />. <br />.B <br />u <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcelid.com <br />EHD 23-02-003 Rev 10/26/17 CONTINUATION FORM <br />