Laserfiche WebLink
oea"I". SAN JOAQUIN COON_/ <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • c;.. .r;P Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.siaov.orD/ehd <br /> 4i Fl)R <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: e�� Date: 1 — -- <br /> ddress: 2\ � ��—� City: Zip Code: <br /> wner/Operator: 1�\e 3� V—A Telephone: <br /> Program Element: \ ��2 -Program Record: 00, Inspection Type: <br /> 8180 Posted Yes Cl No Permit Posted Yes '° No Re-Inspection on or After: <br /> 3JBSERVA _, ' <br /> G0, r� <br /> \ -te v' - 1 O�F b <br /> CO <br /> \ d e <br /> 2 rn \ O` c7 <br /> \, <br /> A <br /> 1 <br /> s2� t3 <br /> ,-.,.- ity Hot Water Temperature Warewashing <br /> ame: IHand Sink: `F Chlorine: PPM Heat: of <br /> Exp.Date: rewashin ink: 12-� of oust.Amm.: PPM ther: of <br /> Received By/Title: <br /> H Specialist: - Phone: 1_Vssc) <br /> Time In: Time Out: '1 `2 Q Pagel o} <br /> EHD 16-24 (2-pg) 4/311 L �l.J FOOD PROGRAM OIR CONTINUATION <br />