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0" 4MIN 0 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />600 East Main Street, Stockton, CA 95202-3029 <br />May 1, 2012 <br />VT <br />3250 Hammer Lane <br />q <br />T <br />Hlsp.-S',"Aris Cacapit <br />1. 1 have corrected the violations specified in the Inspection Report from the above-mentioned <br />inspection date. <br />1101- <br />ILYA LSIV-11 I Lelilk F-1 Tao I WoM INAT'Nal PA -11 I fell .1mar,91i <br />Photos Paperwork 4k2Statement <br />4. 1 am aware that there are significant penalties for submitting false information, including the <br />possibili'��l a fine and/or imprisonm nown violations. (HSC 25191) <br />Name: —Title: <br />V) — <br />IL-- Date: ) 1 '2___ <br />EHD 22-02-005 Rev 09/11 <br />