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SAN 10 A Q U I N Environmental Health Department <br /> C '7lJ i�1" Y <br /> Food Program Complaint Inspection Report <br /> Facility Name and Address: KFC/A&W#284,4450 E WATERLOO RD,STOCKTON 95215-2306 <br /> The person in charge is responsible for ensuring that the above mentioned facility is in compliance with all applicable sections of the California Health and <br /> Safety Code.If a reinspection is required,fees will be assessed at the current hourly rate. <br /> U y "J� <br /> Received by: Name and Title: melissa osbom,assistant manager <br /> EH Specialist: VICTOR ACEVEDO Phone: (209)468-0337 <br /> FA0014100 C00050651 SCO04 10/10/2019 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program Complaint Inspection Report <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />