Laserfiche WebLink
Q�a"'"'•r `r' SAN JOAQUIN COUI.f <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> e4... s Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.siciov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: C x pre'� 5 M& r. K ` Date: r, -;F,/ <br /> Address: 14 S YYI t. n -, Com' e n It r.1 zip code: 9 s 3 3 t <br /> Owner/Operator: Telephone: 2 9_ (' ;If/ <br /> Program Element: Program Record: Inspection Type: C 11 I hC <br /> B180 Posted - Yes No Permit Posted -Yes No Re-Inspection on or After: <br /> RVATIONSyl= ACT <br /> _ n 1kise <br /> ... <br /> dlr roll r jo.,3 ;Qi/ tea' , ;01 <br /> w; Or h e If wy l F C / <br /> i { 6 O /'G iii/ S <br /> Pso th j- <br /> h S(, b rn h .5 i m d l ii-c' <br /> 3 rc,,; de hec h tM; f an G i n rcl iGr1 <br /> I'P Ot'\ S . /-o• <br /> r; ur G Are. <br /> 0 e4 • d; s 49F AhW all -; n <br /> - <br /> Food Safety Certification FF�n <br /> ct of Water Temperature Warewashing <br /> Name: ,nk: F Chlorine: PPMHeatExp.Date: ashing Sink: �ZU of uat.Amm.: PPM (Other: eF <br /> Received By/Title: <br /> EH Specialist: V Phone: f.j 16 <br /> Time in: Time Out: !' Paged of <br /> 10'U V <br /> EHD 1624 (2n°pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />