Laserfiche WebLink
SAN JOAQUIN COUKv <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • r... ;P Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siaov.org/ehd <br /> ,ciFua�' <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: S .` #'Z CDate: / j.6 / Y <br /> Address: Y G I W i 1l. $4 City: ' ( Zip Code: <br /> wner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: -C _h <br /> 8180 Posted Yes No Permit Posted Yes No Rrinspection on or After: <br /> on, 41 Zor hot )It -k . n " 'Vie,5 ,5 hu O <br /> �. erjr 1Cd $@ ✓eral ro` be /1 !e•g lA/GV AC' I <br /> 4 c e1 o 1 3 ' CCma 'hes <br /> cb C1, ACwee Il <br /> Ar, lC r <br /> • �s1 /: y n 1 Pe <br /> Cu b..,n 4j hlavl c" I d ,. C/( <br /> of bticK We ; AlmY .5 <br /> ri r 10 11; n jfN 1S G W << rYPC -FP <br /> I, <br /> r 14-AX G 4ef Q n 3'LGNI ,) /oc✓ S : 1 <br /> P 6-, r ,rih ( �h <br /> 0bC'r1' f.2-'/Ocr U/lrl ;ii, ct : n <br /> / . ✓0 o &IWn W- 4h btA . 141-u //' A .1 f6- Al <br /> L PY G 1 4. <br /> ( <br /> I C4 11, A 1C <br /> 5An i zer — 160 2-r1g, 4ifLG M a < GG C /or r✓1)ti <br /> A e r a - i N1 rfie 1; <br /> —' Food Safe tion aeility at Water Temperature <br /> Name: Hand Sink: •F Chlorine: ppm ; 16,1 °F <br /> Exp. Date:- 1 1J arewashing Sink: y y�J-,Lr -F Ouat.Amm.: 2C_. ppm Other: of <br /> ESpeciallst: <br /> By/ /S.Yl54 Cr <br /> Phone: (�6 -T/(, J' <br /> rl Time Out: 3 3 Pageif <br /> EHD 16-24 (2n°Pg) 4013 FOOD PROGRAM OIR CONTINUATION <br />