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SERVING <br /> BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT city of Lodi <br /> ,lamer Culbertson,Pres. San Joaquin County <br /> Mary Anna Love,Vice Pres. 16(11 East Hazelton Avenue, P.O. Box 2009 San Joaquin County <br /> Patricia E.vannuccl,Secy. Stockton, California 95201 City of Eacalon <br /> Tommy Joyce City of Manteca <br /> Earl Pimente) (2(19) 4b6-6781 City of Ripon <br /> Virginia Mathews City of Stockton <br /> Daniel L.FloresCity of Tracy <br /> John D.Mast,M.D. Jogi Khanna,M.D.,M.P.H.;District Health Officer San Joaquin County <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> i <br /> DATE 6 7 `r1177 <br /> FACILITY <br /> OWNER/OPERATOR <br /> ✓` <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT REPRESENTATIVES <br /> hereby, agree to have all violations <br /> per in ort..( s ) dated _�—&q— pertaining <br /> to the above referenced establishment corrected on or before <br /> 7 - � � . . <br /> I 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 /> 4,,q SIGNED BY PROPRIETOR <br /> 52 2 <br /> -J� 7 f <br /> EH 00 42 (Rev 7/88 ) <br />