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P4 '" SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> Q, < <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> '�CIFORN <br /> OFFICIAL INSPECTION REPORT <br /> DATE: <br /> FACILITY NAMEITYPE: "--« <br /> CITY: ZIPq ODE: <br /> ADDRESS: l$<o£3H <br /> TELEPHONE#: <br /> OWNER/ ER OR: .&,;7 g <br /> G"'7 C :'I <br /> PROGRAM RECORD <br /> ❑ <br /> TYPE OF INSPECTION: COMPLAINT CONSULTATION ❑ OTHER ELEMENT: <br /> NATURE OF COMPLAINT/CONSULTATION: <br /> OBSERVATT,I.ONNSICOMMENTS: <br /> 0 AV <br /> Z yJ 7 <br /> i GAJ ZlGT<> �� i <br /> CORRECTIVE ACTIONS: <br /> CORRECT BY: A,1 <br /> ii <br /> INSPECTED BY' <br /> RECEIVED BY: DATE: <br /> �ly <br /> Inspection Report <br /> EHD 48-05 <br /> 4/9/12 <br />