Laserfiche WebLink
SAN JOAOUIN COU! + <br /> �: •.o <br /> ' ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c� a; Telephone:(209) 466-3420 Fax:(209)464-0138 Web:www.sjqoy,oLg/ehd <br /> I'O®D PROC.,RQNI OFFICIAL INSPECTION REPORT <br /> i <br /> Name of f=acility: Date: <br /> Address: City: Zip Code: <br /> OwnerlOperator: �0 Telephone: .. sY;71j <br /> Program Element:/�Q Program Record: Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> -� <br /> z fJBSER11jA 1� t+1i3, FCFiCT1/EA7f ` - ; , F .�._ <br /> e <br /> _.-A2�•5-le_........................_....... <br /> _-._ ------ ._--- __.._------- - <br /> �ij pG`f4-- <br /> /01 <br /> 4-/ <br /> v n _ <br /> r%O <br /> k <br /> mtdirT-��ocat�on <br /> . Nmw <br /> ` :-- >=oo Sa#� Ger#r s,..4�on, actldy►s of VY Temperature t. y � <br /> I.1.1 a Finn <br /> Name: Hand Sink: �/ of Chlorine: Meat: �F <br /> Exp.Date; arewashing Sink' a oP Ouat.Amm.: PPM Other. -F j <br /> Received Byl"Fide: <br /> 6 <br /> EH Specialist: Phone: <br /> ime in: �/ Time Out, �a �� Pae <br /> of <br /> EHD 16-24 {2a°pg} 4x13 FaW PROGRAM OR CONTiNU TION <br />