Laserfiche WebLink
.. I <br /> SAN JOAQUIN CO6Y <br /> r` ENVIRONMENTAL HEALTH DEPARTMENT <br /> ar :< <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �. Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siaov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Y ,Lr Date: <br /> ddress: City: Zip Code: <br /> Owner/Operator: L•v r C�—J(V Telephone: 9(0—:s y-;I.�W D <br /> Y <br /> Program Element: Program Record: IZ �� Inspection Type: /C_�U ticu , <br /> FB180 Posted Yes ❑ No Permit Posted ❑Yes ❑ No Re-inspection on or After: <br /> C_.C) <br /> son <br /> 00 t �► I�IS <br /> _...v .... r �..a.:r... <br /> r lo G r-e- <br /> Ye rn0 <br /> ' rl <br /> 4 0- <br /> 4- uy -k r bs no ho+ Lk o r <br /> 1.z r <br /> r Y! CA- <br /> ►'b lNf CLQ r n <br /> Y� <br /> ea <br /> rc�i rrt 25 <br /> ;... _. y <br /> mm <br /> ,. It _XEiatsii .. :., ;sten#,1.t�cttn, inperatre <br /> ►n i- C�'u c.R�,n -�C t�Grs I 1° <br /> 36,o 0 <br /> sow <br /> M� g <br /> Name: 1 �� Hand Sink: eF ovine: toc> ppm Heat: of <br /> Exp.Date: f arewasFi' g Sink: 4rv%D , o f ppm Other: '17 <br /> Received By/ <br /> 1 J <br /> EH Specialist: Phone: <br /> Time in: Time Out: Page of <br /> x:157.q <br /> EHD 16-24 (2^4 pg) 4!9!12 FOOD PROGRAM 01R CONTINUATION <br />