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°Pau'"c Environmental Health Department <br /> S A N�J O A Q U I N <br /> `=��Oc <br /> Q: <br /> COUNTY <br /> CP <br /> gcrFoa�' Greatness grows here. <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: ; - P �J v Z) 00 I `00 <br /> ADDRESS: CITY: jr ZIP CODE: c��d <br /> jr� <br /> OWNER/OPERATOR: t �.. `•, r �nTELEPHONE#: 1105 <br /> TYPE OF INSPECTION: LJ COMPLAINT CONSULTATION ❑ OTHER PROGRAM ;j Z��� RECORD <br /> ELEMENT: ID#. <br /> NATURE OF COMPLAINT/CONSULTATION: <br /> OBSERVATIONS/COMMENTS: <br /> / i <br /> rl � <br /> y r , <br /> J <br /> CORRECTIVE ACTIONS: <br /> L <br /> r /r n <br /> 7cnm 0-M <br /> 7 / <br /> CORRECT BY: <br /> INSPECTED BY: <br /> RECEIVED BY//P jw, <br /> `t Q -5a Q r /�(n DATE: <br /> EHD 4E-05 Rev. 10/26/2017 Inspection Report <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />