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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.socehd.com/index.html <br />CONTINUATION FORM <br />OFFICIAL INSPEC ION REPORT <br />Page: of <br />Date: <br />Facility Address: -ter <br />Program: <br />-2 C-> <br />v f <br />/u . % e % 2C 14%1 u W /tI' e-4� <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: <br />Received By: <br />Title: <br />EHD 23-02-003 Rev 04/02/14 CONTINUATION FORM <br />