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PUBL?C, HEALTH SERtCES <br />SAN JOAQUIN COUNTY <br />JOG[ KHANNA N.D., M.P.H. <br />Hea[ch Officer <br />P.O. Box 2009 • (1601 Fast Hazelton Avenue) • Stockton, California 95201 <br />(209) 468.3400 <br />ADMINISTRATIVE HEARING AGREEMENT <br />DATE <br />FACILITY mss' C Kew g3 <br />ADDRESS 20 7Z-- <br />OWNER/OPERATOR <br />Z- <br />OWNER/OPERATOR <br />San Joaquin County Public Health Services -Environmental Health Division Representatives: <br />hereby, agree to have all violations per inspection <br />report(s) datedz/�pertaining to the above referenced <br />facility/premises corrected on or before /%f3 . (All reinspections <br />will' be assessed at a rate of W. per hour.) <br />I further agree that said violations may be detrimental to the public health and/or safety and <br />will prevent these violations from recurring. I understand that failure to comply with this <br />agreement will result in further legal remedies and/or may result in the closure of my facility <br />through suspension or revocation of my Environmental Health Permit. <br />COMMENTS: <br />, MMA4 <br />,�'� <br />/' ' <br />EH 0042.Gen (Rev 7/2/91) <br />Proprietor's Signature <br />• A DWbim of San Joaquin County HWth care Ser mca <br />uwle- <br />