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°°i4UIN' ° SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N:•�II' < <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • Cq._� •,•�P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:WWW.sjgov.org/ehd <br /> �1FpR� <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: , DATE: <br /> ADDRESS: ��,���j A t I' , � , CITY: `�L.�,� ZIP CODE: <br /> OWNE PERATOR: TELEPHONE#: <br /> TYPE OF INSPECTION: ❑ COMPLAINT ❑ NSfc-oULTATION Outjh�THER PROGRAM RECORD <br /> ELEMENT: 142,4L+ ID*: Pg a�;3 3 41 q <br /> NATURE OF COMPL LTATION: " (y _ <br /> r <br /> ,C4r-le _ 61 z1 <br /> w J- <br /> � _S s <br /> CORRECTIVE ACTIONS: <br /> CORRECT BY: <br /> INSPECTED Y 0-7"L'–' r <br /> RECEIVE <br /> EHD 48-05 Inspection Report <br /> 4/9/12 <br />