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$ANsJUQQUIN Environmental Health Department <br /> -COUNTY- <br /> Site Location: ,.► SR#or WP#: <br /> City: Date: <br /> G\ <br /> � x <br /> a� T7R Y A uu <br /> 1 Li,& <br /> 2,5 <br /> G' <br /> J � J <br /> � � x <br /> l <br /> N <br /> 1868 E. Hazelton Avenue Stockton, California 95205 T 209 468-3420 F 209 464-0138 1 www.sjcehd.com <br />