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PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY '�' •�'c <br /> JOGI KHANNA M.D.,M.P.H. <br /> HtOfficer � r„ <br /> P.O. Box 2009 . (1601 Case Hazelton Avenue) Swc e� i 1'\\'{,\\ • e i;oP <br /> V 1i Nor <br /> (209) 468-3400 <br /> ADMINISTRATIVE HEARING AGREEME NEP" <br /> ENS�M ACES <br /> DATE <br /> FACILITY <br /> OWNER/OPERATOR <br /> PUBLIC HEALTH SERVICES OF SAN JOAQUIN COUNTY, ENVIRONMENTAL HEALTH <br /> DIVISION REPRESENTATIVES "Z/ �� S <br /> I, �nss l c cP NULL. hereby, agree to have all violations per inspection <br /> rs"eated Q _ _ yp pertaining to the above referenced <br /> establishment corrected on or before <br /> I further agree that said violations may be detrimental to the public health and/or safety and will <br /> prevent these violations from recurring. Failure to comply with this agreement will result in further <br /> legal remedies. <br /> SIGNED BY PROPRIETOR X <br /> (—/O-<a rtie p (gyp >�Gt ,,7111 761' f vuoy�nw.rr��/u�r, lv f�c <br /> G� wu rjc c�,/�/, <br /> A Division of San Juagnin County Hcalit,Care services `� <br />