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2 " r" SAN�IOAQUIN p <br /> Op,,...... C <br /> Environmental Health Department <br /> COUNTY <br /> �crFbac`� Greatness grows here. <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: SF I <br /> DATE. 012-1 <br /> b I/+2-( Z& <br /> ADDRESS: U /t,Q� I o r QQ CITY: < G I/ O� ZIP CODE: �a I <br /> OWNER/OPE(RATOR: (�� (� J Y� TELEPHONE#: <br /> TYPE OF INSPECTION: ❑ COMPLAINT CONSULTATION ❑ OTHERPROGRAM RECORD <br /> ELEMENT: l p��� ID#: S`��Q g a <br /> NATURE OF COMPLAINT/CONSULTATION: Qom►/( 0kgrQ( .)PN O PiSTYfl p ��J <br /> OBSERVATIONS/COMMENTS: <br /> GOk VWckt .G� <br /> CORRECTIVE ACTIONS: <br /> CORRECT BY: <br /> INSPECTED BY: V s <br /> RECEIVED BY: �l•l DAL_ ZT <br /> "CYC \C1 Z 1 ZU <br /> EHD 48-05 Rev.10/26/2017 Inspection Report <br /> 1868 E. Hazelton Avenue Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjcehd.com <br />