|
r=
<br />CONTINUATION FORM
<br />OFFICIAL INSPECTION REPORT
<br />Page: .Of „'-_
<br />Date: Zl- /5 -lc�)
<br />Facility Address: I i !.' , G� '�� ,
<br />Program:- ;,
<br />SUMMARY OF VIOLATIONS
<br />CLASS I, CLASS II, or MINOR -Notice to Comply)
<br />.y I f
<br />- i"' " �. %� ,:„ , rt>u °� ,.c, _.. �C ��s,_. rpt f'sn w-- m. /'24 `�if° ti
<br />� A
<br />"i", 1 �n C.c. § 1...f �� £..c.{� -• a /
<br />1 { ..yl t'r r. ,-F E.. t ..' � C,, ck)f.-6`.,:
<br />t `
<br />, ," tr�,� �°. 1 y� 1 � f e,� �.�a
<br />G� �'1C_:� "C° ::� �'j �'t i
<br />1 ` �
<br />f gg r! p r
<br />1
<br />..��-�-�'�{ +. �f #�l F7. ,�,'u� { ,.,y' d;.G'i'`w: �`i L.� P. L°,y, I ...i'.t f��v� r` �" a,���e•�$`c',� a..�`I r (� �C �X.....
<br />- r �� 8 w, ,
<br />i
<br />'.:. '7 .4n, e:.'.
<br />pp,,
<br />4 !r (2���.
<br />- j .. to 4.�:/ �% C.r.+^. d 1 i.
<br />s �
<br />41
<br />1, °' r^4E •..... P'L i l� �/ ..fi:nGi 4- �",7 ! �''➢tPy;: F by
<br />r
<br />,� {. �� „ F t' � !`iL:.." �,yY�7'� n J 6`a K• i/ (f � �� �� iY - /.'J� ('. '�' � � rl�v � i^�P,,:�P.: ��
<br />,_ry�',t�J
<br />�,[y
<br />ff
<br />,R""YV-"itC �E��,.i'r<^, '��_ ,r ,F'GrAi(Iv, qa,•��^.�... .G��., ,...'l".-':>'„, "C�f y� l�.�t%. 4''t ir�"'j-"...'.
<br />1 7te 17!j:- xr "{f_r` il' r, L)i� y,4.,r , r=�..1 Pti✓ � ' i •.+� f(.. j. h �jP_ �` ; 6: t,'..n.. 'P-'. �' �liw.. .-'°
<br />r2i
<br />ALL EHD STAFF TIME ASSOCIATED WITH FAILING TO COMPLY BY THE ABOVE NOTED DATES WILL BE BILLED AT THE CURRENT HOURLY RATE ($115).
<br />(.�(.� 'J �.d "t"`. '�^61iie' en�' s;°, �:r da✓�A^- `1"...' `-. .,,-;�.,�,,. � � '
<br />THIS FACILITY,I S' BJECT TO REINSPECTION AT AIRY- J) E AT EHD'S CURRENTHOURLY RATE.
<br />3
<br />EHD In ec.
<br />6 w �.
<br />i d By
<br />Tlt,lPeR
<br />�,..- Jg�/ q✓/�
<br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT
<br />600 EAST MAIN STREET, STOCKTON, CA 95202
<br />Phone: (209) 468-3420 Fax: (209) 464-0138 Web www.sjgov.org/ehd
<br />EHD 23-02-003
<br />RF\/ 11/95/09 CONTINUATION FORM
<br />
|