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_ S, OUQUI <br /> -COUNTY- <br /> - Environmental Health Department <br /> f �P. <br /> Site Location: ,?ye99 Al, f LCpR[ r�,p SR# or WP#: <br /> City: 74604M fo Date: Q 2� / I <br /> lav' <br /> i <br /> d . <br /> �oP <br /> l <br /> I <br /> 1 <br /> 3 Ll2 <br /> 1868 E. Hazelton Avenue Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />