Laserfiche WebLink
�g N cAc u SAN .JOAQUIN COUM.,/ <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sogov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: I- 7-1s <br /> Address: .5 �)i_, City: / zip Code: G S 3 If _ <br /> Owner/Operator: LI t. Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> S9180 Pasted Yes ❑ No Permit Posted n Yes No Re-Inspection on or After: <br /> "j S C4 n, <br /> a ,� { n. A E W --e 10-so <br /> C )or. r\ ry, (AIA } , ; n Ci Or p belle lOU <br /> r } -) <br /> VPS a Ire par4;C1, b <7orct F s . SAa� Gfin� <br /> +0 M tA We - a bs crboo l rna let, Z/ CCrrec / -N 2 Wer <br /> 1 n 4An C n i n / <br /> Sati , 4izor b vc ke l srs Cor ree- <br /> V / S R 466 hG,S Cra I. <br /> �G r FG <br /> 4 I i : G ' n 2 Weo <br /> 15 d n or <br /> � � . CGlrRG 1 <br /> .__._ . i T <br /> / dc1c, ) U F <br /> Ihcation Facility Hot Water Temperature Warewash' —. <br /> Name: Hand Sink: of hlorine: PPM Heat: >F <br /> Exp.Date: arewashing Sink: -F uat.Amm.: PPM ther: .F <br /> Received By/Title: <br /> , <br /> H Specialist: �- Phone: b6' 3/6 <br /> ime in: Time Out: Pag!�of <br /> EHD 1624 (2-1)9) 4912 FOOD PROGRAM OIR CONTINUATION <br />