Laserfiche WebLink
nA"'"• �' SAN JOAQUIN COU" <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siaov.oro/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: 3 - — <br /> ddress: IF 117111 . 5 city: ; Zip Code: —3 <br /> Owner/Operator: to <br /> - Telephone: 9_ 26�S <br /> Program Element: Program Record: Inspection Type: •J <br /> B180 Posted )(Yes is No Permit Posfed Yes No Re-Inspection on or After: <br /> 'dv2er a&e j, - 200 of q u <br /> k 3) <br /> Name: cuyn and Sink: �� 'F hlorine: PPM r <br /> set: JExp.Date: /;,�„� arewashingSink: /�1 of uat.Amm.: PPm then. <br /> Received By/Title: L ` OAC/ <br /> H Specialist: Phone: q6jr. J 6 0 <br /> ime In: O Time Out: Page of <br /> EHD 1624 (2-Pg) 4912 FOOD PROGRAM 018 CONTINUATION <br />