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PUBLI HEALTH SER ICES <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 0 P. 0. Box 388 * Stockton, CA 95201-0388 <br />209/468-3420 <br />FACII= <br />ADDRESS <br />OWNER/O: <br />San Joaquin County Public Health Services -Environmental Health Division Representatives: <br />W9910 -WAN MWIM <br />L hereby, agree to have all violations per inspection <br />Or <br />report(s) dated ftktftwi- Z a 1 pertaining to the above referenced <br />I <br />facility/premises corrected on or before 1 ?4 -T19i-- (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 />]� <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 />C� <br />CONB4ENTS: <br />ER 0042.Gen (Rev 8/11/93) <br />Proprietor's Signature <br />A Division of San Joaquin County Health Care Services <br />