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" u......c SAN�IOAQUIN p <br /> Environmental Health Department <br /> Q <br /> COUNTY— <br /> Greatness <br /> GUNTYGreatness grows here. <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: DATE: / <br /> i <br /> ADDRESS: — / I I A /OO_I r O CITY: A����� a ZIP CODE: <br /> OWNER/OPERATOR: �j . ��/ CLJ - TELEPHONE#: <br /> TYPE OF INSPECTION: ❑ COMPLAINT U-CONSULTATION ❑ OTHER PROGRAMi ECORn _���^ O <br /> ELEMENT: S(z0 `f <br /> r <br /> 14 <br /> NATURE OF COMPLAINT/CONSULTATION: ' b ;}L ' <br /> OBSERVATIONS/COMMENTS: C- `•v :,' _5 I{�I�c; �^ <br /> e s O S '� U <br /> lYM t w1 <br /> CORRECTIVE ACTIONS: <br /> CORRECT BY: <br /> INSPECTED BY: <br /> RECEIVED BY: DATE: ILJ <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 />