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BOARD OF TRUSTEES <br />Jamaa QAbwhon. Pray. <br />Mary Anna t.ora, Vim Pros. <br />Patricia G Vannucck Sac'y. <br />Tommy Joys» <br />Earl PMnonbl <br />Virginia Mall a <br />Danhf L Fl r <br />John D. Mast, M.D. <br />SAN�AOUIN LOCAL HEALTH DISTRiJO SERVING <br />CH. M I Mu <br />1601 East Hazelton Avenue, P.O. Boz 2009 San Joaquin county <br />San Joaquin County <br />Stockton, Calffomla 95201 Cay a Facaion <br />Cay of Maniacs <br />(209) 466-6781 city of Ripon <br />City of Stockton <br />Joyl Khanna, M.D, M.P.H., District Huhh Oflicar City of Tracy <br />m Joaquin Counly <br />ADMINISTRATIVE HEARING AGREEMENT <br />DATEk'%%/8p (7 <br />FACILITY R..4 . 6A' -1PC '" �,Vo 0Ps,..&—�t i to dA: <br />OWNER/OPERATOR <br />SAN JOAQUIN LOCAL HEALTH DIV <br />ISTRICT REPRESENTATIVES ��ji�1c2 �rLl <br />I, 6& ki: rl191-k, , hereby, agree to have all violations <br />per inspection report(s) dated 3 12 $18 g pertaining <br />T <br />to the above referenced establishment corrected on or before <br />II further agree that said violations may be detrimental to the <br />public health and/or safety and will prevent these violations from <br />recurring. Failure to comply with this agreement will result in <br />further legal remedies. <br />t� <br />0 <br />/j 1 SIGNED BY PROPRIETOR <br />