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SANzJ0A0UIN <br /> � Environmental Health Department <br /> � { <br /> - -- :.; COUNTY— <br /> .... <br /> cgiFoa `P Greatness grows here. <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: DATE: <br /> 6 I2q'2 0 2a <br /> ADDRESS: 2015- F CITY: ZIP CODE: n�n <br /> OWNER/OPERATOR: TELEPHONE#: 32^ J L86-7-1 <br /> TYPE OF INSPECTION: LJ COMPLAINT IO CONSULTATION LJ OTHER PROGRAM RECORD I}� <br /> ELEMENT: �D �. ID#: S�a� g 22,5D <br /> NATURE OF COMPLAINT ONSULTATION4 <br /> wN S <br /> dtsbiAC,b*fv bunk �ffiy Well . <br /> OBSERVATIONS/COMMENTS: <br /> of t4ev-sougt. Zdid- rwt <br /> ` <br /> j IJ <br /> Y r <br /> Curr wa w i S` <br /> CORRECTIVE ACTIONS: <br /> , <br /> CORRECT BY: <br /> INSPECTED BY: 60 <br /> RECEIVED BY: DATE: <br /> EHD 48-05 Rev.10/26/2017 Inspection Report <br /> 1868 E. Hazelton Avenue Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjcehd.com <br />