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XLETI <br /> SAN JOAQUIN COUNTY <br /> ,n; ENOIONIVIENTAL HEALTH DEPARTME19 4 <br /> 1868 East Hazelton Avenue,Stockton,CA 95205-6232 CERT A <br /> Telephone:(209) 468-3420 Fax.(209)464-0138 Web:www.sjgov.org/ehd �+— lAacC <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: DATE: j <br /> jg <br /> ADDRESS: ITY: ZIP C E: <br /> d 1 o ' ,� 224 <br /> OWNERIOPERATOR: TELEPHOI # <br /> L - <br /> TYPE OF INSPECTION: ❑ COMPLAINT ❑ CONSULTATION OTHER PROGRAM RECORD <br /> ELEMENT: ID#: l�{i <br /> om so <br /> NATURE OF COMPLAINT/CO <br /> NSULTATION: <br /> OBSERVATIONS/COMMENTS: <br /> —. e_ c��w <br /> CORRECTIVE ACTIONS: <br /> CORRECT BY: <br /> INSPECTED BY: <br /> RECEIVED BY: DATE: <br /> l <br /> EHD 48-05 Inspection Report <br /> 4/9/12 <br />