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Pa�'y San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... P Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> ��fFORa <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: YOSEMITE BOTTLE SHOP, 943 E YOSEMITE AVE , MANTECA 95336 <br /> NOTES <br /> Pre-packaged food only <br /> OK to permit as a 1615 once annual permit fee is paid. <br /> Return to 1868 E Hazelton Ave. in Stockton to pay the annual permit fee of$237 by 3 business days. <br /> The person in charge is responsible for ensuring that the above mentioned facility is in compliance with all applicable sections of the California Health and <br /> Safety Code.If a reinspection is required,fees will be assessed at the current hourly rate. <br /> Received by: Name and Title: <br /> EH Specialist: KADEANNE LINHARES Phone: (209)468-0330 <br /> FA0001408 SR0077969 SC061 07/28/2017 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program Service Request Inspection Report <br />