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PUBLIC HEALTH SERVICtS <br />�o <br />SAN JOAQUIN COUNTY Q �" <br />ENVIRONMENTAL HEALTH DIVISION ; <br />Karen Furst, M.D., M.P.H., Health Officer . <br />304 East Weber Avenue, Third Floor • Stockton, CA 95202 9`1700 <br />209/468-3420 <br />ADMINISTRATIVE HEARING AGREEMENT <br />DATE Z <br />FACILITY <br />ADDRESS <br />OWNER/OPERATOR L!/cl�Ges �Tcgr� <br />San Joaquin County Public Health Services -Environmental Health Division Representatives: <br />�61M <br />I, w4eZZ&4ft / C_7zw_5 , hereby, agree to have all violations per inspection <br />report(s) dated __/271ff7 pertaining to the above referenced <br />facility/premises corrected on or before k - k — ° 7 (All reinspections <br />will be assessed at a rate of $78.00 per hour.) <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. I understand that failure to comply with this agreement <br />will result in further legal remedies and/or may result in the closure of my facility through <br />suspension or revocation of my Environmental Health Permit. <br />COMMENTS: <br />UA Ts, F <br />EH 0042.Gen (Rev 7/28/97) <br />/,/77 / <br />Proprietor's Signature <br />A Division of San Joaquin County Health Care Services <br />