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Id <br />/0 <br />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.swcehd.com/index.html <br />EHD 23-02-003 Rev 04/ !�4 CONTINUATION FORM <br />CONTINUATION FORM <br />OFFICIAL INSPECTION REPORT <br />Page: of <br />Date: <br />Facility Address: 19,155 <br />Program: <br />134 1 Pa'r 4, t)� n <br />C CE a hy-w \ 4. bn O <br />•4` <br />, Q.s 2�0 : ►tom. 4-CMAY= <br />was <br />IA z- a c a,, acv l ec: <br />Cv r U. <br />o. to 6'j 5e^ C <br />W Q S Skv. t i s 4.0 wag <br />Yn <br />CL <br />(k, CK &\ • 3Ca? <br />k. I ' <br />O c., w46J- <br />(Lias-ee .ncQ <br />l )tl w�u1M Y Vt^Y� <br />O <br />0 oz 11 , h <br />S i 11 j <br />W V\ d. <br />v. •- <br />i� � <br />L <br />c rn zx- 4 -�j le,� k <br />`V <br />pp <br />� •Macre._ .�0 l C',C�. aL r �r . - '�,C`I. <br />1-0 <br />Also -4AAA'tvV' <br />a <br />w. <br />R <br />VDVA <br />C It <br />/• <br />J� <br />' r " i <br />:3 f <br />w <br />d <br />_ <br />r <br />.- <br />lM. <br />�(L <br />/,2- <br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE AB VE 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 Insp tor: <br />Received By: <br />Title: <br />EHD 23-02-003 Rev 04/ !�4 CONTINUATION FORM <br />