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PUBLIC FtALTH SERVI(fES <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION X <br /> Karen Furst, M.D., M.P.H., Health Officer <br /> 304 East Weber Avenue, Third Floor Stockton, CA 95202 P <br /> � <br /> 209/468-3420 <br /> ADMINISTRATIVE HEARING AGREEMENT <br /> DATE Z g ' ? :;Z' <br /> FACILITY �t t lC.e4I�F I o I S <br /> ADDRESS ?.0 / 5Zj&@ <br /> OVRiMOPERATOR _94z'&A. •• <br /> San Joaquin County Public Health Services-Environmental Health Division Representatives: <br /> I, lf/a4&oft r'E7Z��C.s , hereby, agree to have all violations per inspection <br /> report(s) dated Zf 7 pertaining to the above referenced <br /> facility/premises corrected on or before (All reinspection <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: 2 <br /> Ts a•. �� <br /> i M7 <br /> Proprietor's Signature <br /> EH 0042.Gen (Rev 7/28/97) <br /> A Division of San Joaquin County Health Care Services <br />