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O PgU'I <br /> SAN JOAQUIN COUNTY <br /> yl < <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd <br /> <IFORN <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: - DATE: <br /> ADDRESS: CITY: I ZIP CODE: (� <br /> ( S <br /> OWNER/OPERATOR: TELEPHONE#: <br /> TYPE OF INSPECTION: COMPLAINT CONSULTATION O,OTHER PROGRAM RECO R /{ <br /> `n Q. ELEMENT: ID#: 7fl-) T'�' <br /> NATURE OF COMPLAINT/CONSULTATION: <br /> OBSERVATIONS/COMMENTS: <br /> U12 <br /> CORRECTIVE ACTIONS: <br /> CORRECT BY: <br /> INSPECTED BY: <br /> RECEIVED BY: DATE: / <br /> O <br /> EHD 48-05 Inspection Report <br /> 4/9/12 C7 <br />