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w <br /> SAN JOAQUIN COUNTY CeJ7 <br /> MENTAL HEALTH DEPARITM Cr <br /> X it .. ERT <br /> F21 <br /> 1868 East Hazelton Avenue, Stockton, CA 952055-6 2=2 <br /> Telephone:(209) 468-3420 Fax. (209)464-0138 Web:www.sjgov.org/ehd <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: DATE: <br /> ADDRESS: ZIP CODE: <br /> CITY: <br /> V 0 <br /> OWNER/OPERATOR: s TELEPHONE <br /> TYPE OF INSPECTION: Ll COMPLAINT 0 CONSULTATION 0 OTHER PROGRAM RECORD <br /> ELEMENT: ID#: r" <br /> NATURE OF COMPLAINT/CONSULTATION: <br /> OBS--:R'IATION'—ZICO,',I-I;ic—NTS: <br /> CORRECTIVE ACTIONS: <br /> J1 L <br /> CORRECT By.. <br /> INSPECTED BY: <br /> RECEIVED BY: t DATE: <br /> EHD 48-05 Inspection Report <br /> 419/12 <br />