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°PnU'"c:a SA6JOAQUIN a <br /> Environmental Health Department <br /> COUNTY <br /> 9ClFORa Greatness grows here. <br /> OFFICIAL INSPECTION REPORT <br /> FACILITYNAME/TYPE: �/G w�Z SPSTFM DATE: 41/197`l <br /> ADDRESS: 101 y rpvCITY: ZIP CODE: <br /> 7 $ S - A-1 APO�2-T w f4-Y M r9-�v7�Gq- 95-3-34o <br /> OWNER/OPERATOR: 60MRL VXLI�yf2�/ ST MUECH TELEPHONE#: �yyvgv- Sg3t <br /> TYPE OF INSPECTION: COMPLAINT ❑ CONSULTATION�❑ OTHER PROGRAM RECORD // <br /> ELEMENT: 416900 ID#: Cam'I93/� <br /> NATURE OF COMPLAINT/CONSULTATION: <br /> 00MPL, lNfi7VF f}U "6)FS MP-' PiOWF pons SSW Ca1v1rhnWb LF4►OAI'ELt IS <br /> rjw)r w;u kArF22s7��►�,. <br /> OBSERVATIONS/COMMENTS: <br /> I2MED 7H tW 5)IST 0 t►5 /vd w 6 -014 i 1.5S3_ <br /> Qr�1'Vtl�lfNN)4�llT .gam�� ✓' ''� J D/IJ�ZLl1S11 �a)�-t �� <br /> o7pWt,e Wim. / W7Vr D✓ n W?4T&M 6VRt47Y 7MRA4 01V R-FZ� <br /> lfN 5HP- MA`r .QTED 774e /SS(),r /s G/I-zY wr71 74,—, COMPIAIAIX s <br /> frP mA tl/V�- No .St�U�L ?6377/VEA, Gco/���� '10 7W I _ <br /> M TO /OA-M 77/✓ </V Ou&- XeUO 05 rlVDT SK 6r%/ <br /> hdtnx,&V),rV(73-, lssS <br /> CORRECTIVE ACTIONS: <br /> (1Vgg,L,F7D Ve I FY f}GLE �D-Gar✓�l' -iitJl= � � ASD_ <br /> CORRECT BY: <br /> INSPECTED BY: &//rvj-07- SA4407 t <br /> RECEIVED BY: DATE: <br /> EHD 48-05 Rev.10/26/2017 Inspection Report <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />