Laserfiche WebLink
opauiN, <br /> � Environmental Health Department <br /> V A N X10 A Q U I N <br /> 1, a . <br /> COUNTY <br /> cgtiFouc`,e Greatness grows here. <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE . r _ DATE : W) 2,5 /Z 01 Cl <br /> ADDRESS : . CITY : ZIP CODE : <br /> -um�r►-er 1-h S-� ctc-br X52 I o <br /> OWNER/OPERATOR : TELEPHONE # : <br /> luk1Q, vVe vn ( Mon y Lisa NurIP £any . Contac 20 `1 - y �+ 8 - ZL�4 <br /> TYPE OF INSPECTION : ❑ COMPLAINT ❑ CONSULTATION )q OTHER PROGRAM RECORD <br /> 1011 CU l l +L{111rY1 Q 1" ELEMENT: Z 3 - i ID#: <br /> NATURE OF COMPLAINT/CONSULTATION : <br /> wI jSS 0% u . n -e S Con con+aI n Mrn erl4� <br /> a CA, <br /> S , o it <br /> r i <br /> OBSERVATIONS/COMMENTS : <br /> Pr YA) LAiwinoe o ( Cc r " i r"lle -t -hlD Vva . p r rm <br /> .Z Z� l w1 • i r <br /> -e C C, S J2 1 n u w1 Con <br /> W 1 -t'h G� U OL fie. 4 002 v IS <br /> Al Cl 00'r AUW1 S . <br /> MON Yb yu su m e PcIsSeed <br /> rg U - qSS ��, <br /> CORRECTIVE ACTIONS . <br /> ID m ' on i vvtr YX~'I - <br /> o i+ t'1 i n a <br /> CORRECT BY : <br /> INSPECTED BY : <br /> RECEIVED BY : 1 l• DATE : <br /> 1100 <br /> EHD 48-05 Rev. 10/26/2017 Inspection Report <br /> 1868 E . Hazelton Avenue Stockton , California 95205 T 209 468- 3420 1 F 209 464-0138 1 www . sjcehd . com <br />