Laserfiche WebLink
SAN .JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT' <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.saciov.org/ehd <br /> {I FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: fr r I Date: /, r <br /> Address: J _ J_ City: Zip Code: <br /> wnerlOperator: ! _X"64 <br /> v� Telephone: <br /> eAt- � �T _X rr a W 3 - <br /> Program Element: &O © Program Record: CaOU 3��' Inspection Type: <br /> 8o Posted l i Yes C No Permit Posted 7 Yes C No Re-inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> r� <br /> ard- o 10 Y7r m� <br /> �J2Y r Y�m ° r- _n <br /> L PC, r r r1 'I rk <br /> r <br /> Lt- <br /> f <br /> ItemlLocation I Temperature Item 1 Location Temperature Item f Location -- Temperature <br /> Food Safety_Certification Facility Hot Water Temperature i Warewashing <br /> Name: Hand Sink: OF [Quat, <br /> hlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: OF Amm-: ppm ther: OF <br /> Received By 1 Ti e: <br /> EH Specialist: h ne: !�J 3 •� <br /> J c <br /> Time in: 315.D Time Out: O Pager of J <br /> EHD 1624{2^d pg} 1112109 FOOD PROGRAM GIR CONTINUATION <br />