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SAN JOAQUIN COUNTY <br /> r ' ENVIRONMENTAL HEALTH DEPARTMENT <br /> a: <br /> m; <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> . `P. Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> 9TtFORa <br /> OFFICIAL INSPECTION REPORT <br /> DATE: <br /> FACI)LITY NAME/TYPE: — :9- <br /> V ZIP CODE: <br /> ADDRESS: CITY: -� <br /> 0 <br /> OWNER/O T EPHONE#: <br /> ORD <br /> TYPE OF INSPECTION: COMPLAINT ❑ CONSULTATION ❑ OTHER PROGRAM REC <br /> ELEMENT: � ID�1 <br /> NATURE OF COMPLAINT/CONSULTATION: <br /> OBSERVATIONS/COMMENTS: <br /> CORRECTIVE ACTIONS: <br /> /cam-sv� <br /> CORRECT BY: /C/ <br /> INSPECTED BY' <br /> RECEIVED r DATE: C �� / 7 <br /> �ti <br /> EHD 48-05 Inspection Report <br /> 4/9/12 <br />