Laserfiche WebLink
°aur" SAN JOAQUIN COUN <br /> 4 ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www,sigov.org/ehd <br /> �lFoa�' <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: , 2 City: �\ Zip Code: CL S <br /> Owner/Operator: J i Telephone: z'4 S <br /> Program Element: 1 w - Program Record: Inspection Type: <br /> SB180 Posted Yes No Permit Posted es No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> v <br /> �. --A- 14 S E +V-Q- <br /> c-11 h.e. � Re ✓ _ � <br /> -S o, <br /> Ilk- <br /> .y s ate 1 Location Temperature <br /> 12 br <br /> rtY.. <br /> Name: Hand Sink: 1 C�6,t -F Chlorine: 12 ppm eat: *F <br /> Exp.Date: \v _ _ arewashing Sink: 1 of Quat.Amm.: ppm ther: o f <br /> Received By/Title: _T7777 .7f <br /> Cn Phone: b <br /> v `1 <br /> EH Specialist: <br /> Time in: i �� Time Out: Pageif <br /> EHD 16-24 (2^^pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />