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Q QU1N"'G� SANAOAQUIN <br />COUNTY <br />gc;Foa Greatness grows here. <br />Environmental Health Department <br />OFFICIAL INSPECTION REPORT <br />FACILITY NAME/TYPE: <br />I <br />DATE: <br />ADDRESS: <br />CITY: <br />iN <br />ZIP CODE: 2 <br />S gZ <br />OWNER/OPERATOR: <br />TELEPHONE #: <br />TYPE OF INSPECTION: ❑ COMPLAINT CONSULTATION ❑ OTHER <br />PROGRAM <br />ELEMENT:\J\20b <br />RECORD <br />ID#: <br />�c�v <br />NATURE OF COMPLAINT/CONSULTATION: <br />OBSERVATIONS/COMMENTS: <br />CORRECTIVE ACTIONS: <br />PS <br />CORRECT BY: <br />INSPECTED BY:Qk,,-,\ <br />RECEIVED BY: '� A <br />DATE: <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.sicehd.com <br />