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PUBL1(--!HEALTH SP�UIN. <br />SAN JOAQUIN COUNTY <br />r. <br />ENVIRONMENTAL HEALTH DIVISION e <br />Ernest M. Fujimoto, M.D., M.P.H., Acting Health Officer <br />304 E.Weber Ave., 3rd Floor • P. O. Box 388 • Stockton, CA 95201-0388 <br />209/468-3420 <br />DATE <br />FACILITY (- J -tom i C- Z'ST' o Z�s <br />ADDRESS I Se kJ k6a, s <br />OWNER/OPERATOR © LAI V.- <br />San <br />LSan Joaquin County Public Health Services - <br />I, , hereby, agree to have all violations per inspection <br />report(s) dated 1 riQ L_ 4- �Qs� pertaining to the above referenced <br />facility/premises corrected on or before (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 />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 />COMMENTS: <br />EH 0042.Gen (Rev 8/11193) <br />--Z-W n'/,4 ) <br />Proprietor's Signature <br />A Division of San Joaquin County Health Care Services <br />