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tTt N <br /> SAN JOAQUIN COUNTY <br /> i ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> o. P Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> �Ci F o RNA <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: DATE: <br /> ADDRESS: CITY: ZIP CODE: <br /> OWNER/OPERATOR: TELEPHONE#: <br /> TYPE OF INSPECTION' COMPLAINT ❑ CONSULTATION ❑ OTHER PROGRAM RECORD <br /> ELEMENT: �� ID$: - <br /> NATURE OF COMPLAINT/CONSULTATION: <br /> 12 y/'04g-' -e- <br /> OBSERVATIONS/COMMENTS: <br /> OBSERVATIONS/COMMENTS: <br /> TG = /Y A--& ��c-rL-gtnE,17 - 4liv <br /> eF ./ <br /> v � 5 c L«-iS •- Z r <br /> q?5 ;f- L % Lam-tom' <br /> CORRECTIVE ACTIONS: <br /> CORRECT BY: - <br /> INSPECTED BY:, <br /> RECEIVED BY: DATE: <br /> EHD 48-05 Inspection Report <br /> 4/9/12 <br />