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DactOtN .o SAN JOAQUIN COUNTY <br /> 2� —tri: •:G <br /> y'. < <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> q• ._, P Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> ��FORN <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: DATE: -116117 <br /> 1 /b/I 7 <br /> ADDRESS: Ooo RC1 '•11— �CITY: �fZIP ODE: 9S 3OLi <br /> OWNER/OPERATOR: neyN� � TELEPHONE#g25,C-7�4 7 <br /> �j 0- Se�acl,� JJ 7 <br /> TYPE OF INSPECTION: X COMPLAINT ❑ CONSULTATION ❑ OTHER PROGRAMU RECORD <br /> ELEMENT: ISOU ID$:Cd `7 <br /> 73 <br /> NATURE OF COMPLAINT/CONSULTATION: <br /> OBSERVATIONS/COMMENTS: <br /> CS <br /> � co <br /> 'CS Q <br /> CORRECTIVE ACTIONS: <br /> h C C <br /> CORRECT BY: <br /> INSPECTED BY: <br /> RECEIVED BY: 4 q1 pn DATE: <br /> EHD 48-05 <br /> 4/9/12 Inspection Report <br />