Laserfiche WebLink
SAN JOAQUIN COUN' <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> -_ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s' ov.or /ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: C U ! Date: <br /> f s�7_ <br /> Address: 'N 2,0 �� 1{ City; �� Zip Code: <br /> Owner/Operator: '-L'ke� Q Telephone: <br /> Program Element: I 6'_2-r. Program Record. Inspection Type: <br /> B180 Posted yYes No Permit Posted Yes No Re-inspection on or After: <br /> BS RVA7!©N11S4Nb;; R141ECTIV &! T,16NS <br /> kern/Location Ternperatarre% " .. Item IL66atiori: Temperature <br /> Food Safety Certification " 'Facility,list'Nater."Tem er ure _ War'6washing <br /> Name: Q Hand Sink: 100 'f Chiori e: S-� Ppm Heat: 'F <br /> rr <br /> Exp.Date: J y arewashing Sink: of at,Amm.: m Other: of <br /> Received By I Title: <br /> EH Specialist: / ` Phone: 14 <br /> Time in: . Time Out: r DQ�J Y5 Page2 f <br /> EHD 1624 (2nd pg) 413/13 FOOD PROGRAM OR CONTINUATION <br />