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amu'" SAN.AAQUIN <br />COUNTY <br />°q ;Foa`P Greatness grows here. <br />Environmental Health Department <br />OFFICIAL INSPECTION REPORT <br />FACILITY NAME/TYPE: <br />-'r: j'(; <br />/ <br />DATE: / / <br />ADDRESS: 7 <br />h `(� 3 <br />a��e( <br />CITY: <br />zcdt' <br />ZIP CODE: <br />OWNER/OPERATOR: <br />TELEPHONE #: <br />TYPE OF INSPECTION: ❑ COMPLAINT <br />$1 CONSULTATION ❑ OTHER <br />PROGRAMRECORD <br />/� <br />ELEMENT: 2 �.1 <br />ID#: S �7 <br />i <br />NATURE OF COMPLAINT/CONSULTATION: ��, i p ,1 i pv�p"et �7 I1"/t.�Of �L <br />Le �CAC , <br />OBSERVATIONS/COMMENTS: (� <br />r� cJ L c , 6-tc i <br />1 , - r ✓ . 2 <br />L � <br />J� <br />'`Vi'Cl l�luc �'Lcl <br />CORRECTIVE ACTIONS: <br />CORRECT BY: <br />INSPECTED BY: (-. �< < S ��� <br />e a. A-zl '- <br />RECEIVED BY: <br />DATE: <br />IZE <br />EHD 48-05 Rev. 10/26/2017 Inspection Report <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />