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SAN JOAQUIN LOCAL HEALTH blSTRICT !� <br />'sOARo Of TRUST `� i601 East enue <br /> l I zeitoa AvICRYINa <br /> Jan► • G►Ibwlaon, Pune 466.67&I } <br />!rekich C. Vanr►up STOCKTON, CALIFORNIA CAty of Lodi y <br />{Anthon*4lo V*n Sp 1.�+4nin county <br /> i'! <br />'Ew nn+«►4a1 INSPECTION- REPORT roof Manto" F <br />'F�►n a�oe.. <br /> Aanloi L. Flom• ► City of Ripon <br />'John 0. Meat AM . OWacr/OpiErator 4 SS"�,�� � � Sf Ity of Stockton <br /> Dates, I g^ <br /> William J.Wodo I.ocatio � �/ `t t, �E C�.; Gtr of Ttacr <br /> 1ary Anna �ov�a '.! 4quin County <br /> o q inCounty <br /> i, <br /> fl <br /> OPQW—iag e0s'ectians are to be made: <br /> 1=a c i l i ty ..Gv�� ! <br /> Address <br /> Date of 1 <br /> f � <br /> MOHITORIt <br /> Ant <br /> _ <br /> CO . regarding <br /> � <br />! Imo' PL. Pi <br /> V Da �,� r r777 L <br /> ,f.G b <br /> Ca <br /> ally `"" <br /> i <br /> ! <br /> I <br /> lmplemef CIRCLED items': <br /> be compl <br /> Pret t � bmi tted to <br /> thi! .� <br /> Received Notice: } t <br /> 2. Pip, II <br /> rI F <br /> JOGI KHANNA, N.D., MPH, District Health Officer <br /> f Dai ds'maintained ' <br /> at <br /> EH 00 20 Registered Sanitarian q k <br /> 4 . Document dail check of suction lies <br /> �.. Y plping SunG��un ��a. � ...y li <br /> J_ <br /> 5 Submit quarterly: statement to this office that allowable variation on inventory <br /> reconciliation has not been exceeded or a list of dates and/ variAtions that <br /> exceeded allowable. ' The first statement is due by <br /> �6;' Dispenser meter s must be calibrated b _ _ with copy of <br /> w- certification or Weights and taeasures sticker number �st16mitted to this office. <br /> ;i <br /> If the above campliance dates cannot be mei . contact this office prior to the specified , <br /> d.lLe. � <br /> If allowable daily inventory variation is exceeded. refer to Section 7644( { ) for ! <br /> required actions. <br /> 3-86 UGT 1 _— l <br />