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uIM'' SAN .JOAQUIN ACOUNTY <br /> a - - z RON ENTAL HEALTH EPART <br /> 0: X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �q .•�P. Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> OFFICIAL INSPECTION REPORT <br /> FACILITY NAME/TYPE: ' DATE: <br /> 9A% /17 <br /> ADDRESS: ^ CITY: zIP coDE: C2J <br /> OWNER/OPERATOR: TELEPHO #: d <br /> TYPE OF INSPECTION: ❑ COMPLAINT ❑ CONSULTATION OTHER PROGRAM RECORD <br /> ELEMENT: ID#: �a <br /> NATURE OF COMPLAINT/CONSULTATION: <br /> OBSERVATIONS/COMMENTS: <br /> ® Nc <br /> C Q 2 <br /> A <br /> CORRECTIVE ACTIONS: <br /> CORRECT BY: <br /> INSPECTED BY: <br /> RECEIVED BY: DATE: <br /> EHD 48-05 Inspection Report <br /> 4/9/12 <br />