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r� <br />SAN .IOAQUIN 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.sjcehd.com/index.html <br />EHD 23-02-003 Rev 04/02/14 <br />4' <br />s <br />CONTINUATION FORM <br />'� <br />,CONTINUATION FORM <br />OFFICIAL INSPECTION REPORT <br />Page: of <br />Date: --�-�2 �J[ <br />Facility Address: � <br />� : �� �( <br />�� � �.� <br />Program: <br />SUMMARY OF VIOLATIONS <br />(CLASS I, CLASS 11, or MINOR -Notice to Com I ) <br />Z' <br />1 � 0 <br />V �� iQ., <br />� � � \� <br />id� <br />�Q �f�l W <br />� <br />� <br />�� Si <br />�t : R � 0� V <br />� - � .:�, 1 � 53 <br />- <br />S ,S s <br />�'D k.G' <br />� � i <br />`e <br />' o <br />� .2 <br />�-�, <br />v <br />�' <br />� lls� <br />Q--- <br />i <br />r <br />Yp C � � <br />� (:� Q� <br />c <br />V�1 Q <br />� ~ l <br />� <br />� -CCl <br />C��o��st-o +� re, <br />�Jr�-cam. <br />� -�o ,� <br />�s � <br />� <br />(� <br />' Ca�"� p <br />�� �� <br />-� � <br />Cer <br />��� �N� <br />e.d c� —���� <br />� <br />�S <br />� i � �, <br />ALL EHD STAFF TIME ASSOCIATED <br />WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE <br />BILLED AT THE CURRENT HOURLY RATE. <br />THIS FACILITY IS SUBJECT TO REINSPECTION <br />AT ANY TIME AT EHD'S <br />CURRENT HOURLY <br />RATE. <br />EHD Inspector: <br />`'�G.-K---Lv <br />Recei <br />y: <br />V t� In�i' 6 <br />Title: <br />o vt <br />r � �u <br />EHD 23-02-003 Rev 04/02/14 <br />4' <br />s <br />CONTINUATION FORM <br />'� <br />