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FACILITY NAMETTYPE: DATE: <br />ADDRESS: .--) ,•••••" <br /> <br />- . g 9 ri,11,2fick <br /> <br />2 )-9 -C-- +e q 1' <br />CITY: , ZIP CODE: <br />15.22 4-) <br />OWNER/OPERATOR: ç- <br />licG l.k5(14, 49,k0te_S <br />TELEPHONE #: <br />TYPE OF INSPECTION: pit COMPLAINT 0 CONSULTATION U OTHER PROGRAM <br />ELEMENT: Zt ' C, <br />RECORD <br />ID#: <br />NATURE OF COMPLAINT/CONSULTATION: 1-billecIA4/Le- bks e_ pf( de evnt, ii) &-- e9iLl 1144 <br />LA-9 t ilA 5 (-A 5,J-e,G4iel r4L-4-4- aLA-,z) e- M-1114 /:., b fitit Si 0 144 c e/74(z A-1k 0,2€1 <br /> <br />cON t Hv i°,-1-0 4., (itta 1,`Ae “, -I- -1.64 tht ow4e,- mecy /a1 , I 1 p,' <br />L-t2 ;: 1 ko wl ,A. 0.0.444:4-_ -17-yeee. e3 0 .-ei,41' c, '4-'t k &Li 4 )i. r <br />66)6'5 A.434 Cd.)ci ard ,I-t <br />OBSERVATIONS/COMMENTS: 0 17Ce ilveti 19 1 041-- -6,Lis1.. vtittic,/ cio Lc,/ zi Pi i i C., <br />'fail 4-, Ott) ctivj 0,..04 44 v C,4 t i,i 1 r cA--/ eh A 7`44, e./(6 <br />i f (0,1 ebe dee' 6r, 5e1.1.,'L cirri it . <br />0,444,r 1I44 lc , 74)({ 47 0 69 Irv-e-- LA-4.4./- fC. L., i L-.. ,46 7L'\4 ,Pu,uted <br />6,411 4 I E,„71 4t 'Lk. ied, . <br />CORRECTIVE ACTIONS: <br />BY: CORRECT BY: <br />INSPECTED BY: FraiLt i',S CV ( e 4 C e 4: 4,/z___ <br />RECEIVED BY: <br />-Li tcc•z-a-e4 <br />DATE: 5— - / - i "2 <br />EHD 48-05 Rev. 10/26/2017 Inspection Report <br />SANAOAQUIN <br /> <br />Environmental Health Department <br />COUNTY <br />Greatness grows here. <br />OFFICIAL INSPECTION REPORT <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com