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PUBLIC HEALTH SERN/ iCES POUlN <br /> SAN JOAQUIN COUNTY ?° . <br /> ENVIRONMENTAL HEALTH DIVISION <br /> Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer <br /> 304 E.Weber Ave., 3rd Floor • P. O. Box 388 9 Stockton, CA 95201-0388 <br /> 209/468-3420 <br /> ADNfMSTRA= HEARING AGREENIF_NT -3, <br /> DATE <br /> FACILITY <br /> ADDRESS i <br /> OWNER/OPERATOR `R'ie-lyA l <br /> San Joaquin County Public Health Services-Environmental Health Division Representatives: <br /> I�r� Wit; 041 (1)11sem, �i I h 9 L44-- <br /> I, hereby, agree to have all violations per inspection <br /> report(s) dated 11��01 r.(� pertaining to the above referenced <br /> facility/premises corrected on or before -.1 Un-6 ZZ, (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 /> COMIVIIIVNTS: I I (*cS <br /> 2 i <br /> �P� �G� �c�----=n/�r'►`�(�l�c d'14 1^C3:i[�1y�a/Y\Q.v� Y�c� lJ��/� <br /> Proprietor's Signature <br /> EH 0042.Gen (Rev 8/11/93) <br /> A Division of San Joaquin County Health Care Services <br />