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SAN 10 A Q U I Na <br /> Environmental Health Department <br /> COUNTY <br /> `•�i ` '�E ' Greatness yrov;s here. <br /> COMPLIANCE SCHEDULE AND AGREEMENT <br /> LOCATION: �{ <br /> \,N <br /> ` H /� K CITY: TY <br /> lj <br /> PROPERTY OWNER NAME: j•O KT—i� <br /> List activities needed to correct all violations and provide the date the activity will be completed. Provide additional specific <br /> information describing the activity:type of unsafe or unsecured condition,type of pre-permit activity(i.e. preparation of <br /> plans, asbestos survey/utility disconnect for demolition), type of permit needed (i.e. local building permit,well or septic <br /> permit,State Housing and Community Development permit),etc. Use additional paper if more space is needed. <br /> COMPLIANCE <br /> COMPLIANCE ACTIVITY DATE FULL DESCRIPTION OF ACTIVITY <br /> Unsafe Condition Securement <br /> Pre-Permit Activities 0 �2$� X11 Y� t UYt�Y�ll�� (J1/ l 'tGL �b � �G�f ��,✓ <br /> } .a L&rb+ tout I l d l n a r 1- <br /> Obtain all Required Permits <br /> GUT( Md M W l f 8 at 'i'tw k � <br /> Repair/Demo Task Z(1Z e <br /> Repair/Demo Task <br /> Repair/Demo Task <br /> Repair/Demo Task <br /> Repair/Demo Task <br /> Repair/Demo Task <br /> Final all Required Permits DTD� 12at fIY1i71 a-e, ft/rY' i1 wi lov: cAt Y'9 dUrojf-W ' } <br /> As the owner of the property or authorized agent of the property owner, I do hereby agree to comply i-vith the <br /> abatement schedule noted above to resolve the violations cited by the Environmental Health Department. I <br /> understand that if these activities are not completed by the dates indicated, administrative fines/penalties may be <br /> imposed and additional enforcement actions may be taken, including referral to the District Attorney's Office. <br /> SIGNATURE OF PROPERTY OWNER/AUTHORIZED AGENT: PHONE.' <br /> TITLE : DATE: <br /> (EHD USE ONLY) <br /> NOTICE AND ORDER TO ABATE DATE: <br /> APPROVED BY: DATE: ,`J�1 IU�r� 12-O 2 <br /> EHD 1300 XXXX 9-2018 6 l L <br /> 1868 E. Hazelton Avenue Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />