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SAN a,J000UIN Environmental Health Department <br /> !A*& ' —COLI'.T <br /> Site Location: _ _ � SR#or WP#: <br /> City: Date: It <br /> ` ff ' <br /> 1 <br /> a <br /> w <br /> f <br /> 1 <br /> "i z" <br /> fi <br /> N <br /> 1868 E. Hazelton Avenue Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />