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oaa�IN. SAN JOAQUIN COUNTY <br /> En_ 'ONMENTAL HEALTH DEPARTME <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-8232 <br /> Telephone: 209 468-3420 Fax: 209 464-0138 Web:wvvw.sjgov.org/ehd <br /> </PORN <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: Jr /y DATE: <br /> ADDRESS: I el C N^„�,/t ,� CI L ZIP CODE: <br /> _1 C „In�C / 5�(UC <br /> OWNER/OPERATOR: TELEPHONE#: <br /> TYPE OF INSPECTION: ❑ COMPLAINT ❑ CONSULTATIO OTHER PROGRAMII RECORD -5L <br /> ELEMENT: ID#: O <br /> NATURE OF COMPLAINT/CONSULTATION: '41 414 <br /> e <br /> r <br /> ii <br /> 'r - <br /> . 'Je <br /> OBSERVATIONS/COMMENTS: <br /> CORRECTIVE ACTIONS: <br /> SOla t' <br /> n ^ n <br /> n <br /> CORRECT BY: <br /> INSPECTED BY: 4'L <br /> RECEIVED BY: �. DATE: <br /> EHD 48-85 Inspection Report <br /> 4/9/12 <br />