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PQuly SAN JOAQUIN COUNTY <br /> E ` OETAL HEALTH DEPARTM <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> 4�1FORa <br /> OFFICIAL INSPECTION EPOT <br /> FACILITY NAME/TYPE: DATE: <br /> Lzot <br /> ADDRESS: CITY: ZIP COD2 <br /> OWNER/OPERA OR: e® A T LEPHONE#' .y <br /> 1 <br /> TYPE OF INSPECTION: ❑ COMPLAINT ❑ CoN§uLTATidNK OTHER PROGRAM RECORD <br /> ELEMENT: ID#: <br /> NATURE OF COMPLAINT/CONSULTATION: <br /> ® ®b <br /> OBSERVATIONS/COMMENTS: <br /> CORRECTIVE ACTIONS: <br /> .s 5 <br /> CORRECT BY: <br /> INSPECTED BY: <br /> RECEIVED BY: DATE: <br /> EHD 48-05 Inspection Report <br /> 4/9/12 <br />