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ENVIRONMENTAL HEALTWI)EPARTMENT <br /> 110-0 SAN JOAQUIN COUNTY <br /> Donna K. Heran, R.E.H.S. Unit Supervisors <br /> Director 304 East Weber Avenue,Third Floor Carl Borgman,R.E.H.S. <br /> Laurie A. Cotulla, R.E.H.S. Stockton,California 95202-2708 Mike Huggins, R.E.H.S., R.D.I. <br /> Program Manager Douglas W. Wilson, R.E.H.S. <br /> cq�iFORa�P g g Telephone: (209)468-3420 Margaret Lagorio,R.E.H.S. <br /> Fax: (209) 464-0138 Robert McClellon, R.E.H.S. <br /> Website:www.sjgov.org/ehd/ Jeff Carruesco, R.E.H.S. <br /> 2 ADMINISTRATIVE HEARING AGGREEMENT <br /> DATE: 3/aql o(p <br /> FACILITY: forge, PadcncL /1 re, <br /> ADDRESS: PO 13ox �03s Linc�eyl CA g5a362 <br /> OWNER/OPERATOR: �Or�e YQ ti Ila, <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT REPRESENTATIVES: <br /> `Jeri Kiz, paherf Cte lion, - lgicAael 4A <br /> hereby, agree to have all violation(s)dated02 <br /> pertaining to the above referenced facility/premises corrected oa-ef+ee are Imni iat4 <br /> (All re-inspections will be assessed at a rate of$93.00 per hour). <br /> I further agree that said violations may be determined to the public health and/or safety and will prevent <br /> these violations from recurring. I understand that failure to comply with this agreement will result in <br /> further legal remedies. -/� <br /> COMMENTS: Jl sw 2CC .5 ota1 t 0o l CL-(jOn S 04 K Cer <br /> CI WAW a t� o�n ire u ' of it <br /> r E ✓e US -1sevep, VeAxJzsJ re - <br /> i -e r a kl -Hr, Fot4r decal nLtmkrs o.4,e on ✓ <br /> to 'S Qmjkir. a <br /> V V d djon a s f. -r b <br /> r Can re I h0A le r reAi` a-fz'onsfor VE h' d o <br /> hht /o <br /> roprietor's Signature <br /> SS.NLS Ltr Rev 9-01 <br />