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SANAOAQUIN <br /> <br />Environmental Health Department <br />COUNTY <br />Greatness grows here. <br />OFFICIAL INSPECTION REPORT <br />FACILITY NAME/TYPE: DATE: <br />3//20,Z I <br />ADDRESS: 1 1 5 Coro- po -l--- r-J_ CITY: ZIP CODE: 95 <br />4 , ",V o 1- <br />OWNER/OPERATOR: 4 TELEPHONE #: <br />TYPE OF INSPECTION: 0 COMPLAINT ;EC CONSULTATION 0 OTHER PROGRAM <br />1 ,,,,4 <br />u ,..., <br />ELEMENT: 0.2..... <br />RECORD <br />ID#: 5 ie...00g 3 3110 <br />NATURE OF COMPLAINT/CONSULTATION: vR.4,-;Iry /0 Cir)ebr-2Y) O-c S-e/p-t-C- -±a41. k- 00/18- <br />-Ma.-1-- ce+ incLac..,s. -to Keivit <br />OBSERVATIONS/COMMENTS: Lto GIK-64 5 ,•---johlK..._ 6 5 0- 62)---67 D( --M.D._ hnq, <br />- ko,..K. -6--901 44- 0,4- to kJ e <br />CORRECTIVE ACTIONS: <br />CORRECT BY: <br />INSPECTED BY: <br />- 1) .1,11.1)-- rt) 4CL' <br />DATE: ) RECEIVED BY: <br />EHD 48-05 Rev. 10/26/2017 Inspection Report <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com