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SAN OAQUIN Environmental Health Department <br /> —C O U N T Y----- <br /> Genrness <br /> Site Location: I �2 �ca� SR# or SNP#: <br /> City: 4( vN O Date: c3 I— <br /> fu <br /> S Ifo e I 5- <br /> I <br /> 1 coo � Ice <br /> "Dr ve-t uU <br /> �yq <br /> N <br /> 1868 E. Hazelton Avenue Stockton, California 952051 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com <br />