Laserfiche WebLink
` °�a4 SAN JOAQUIN COUNTY I <br /> . .C�G <br /> X ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ = 1568 East Hazelton Avenue, Stockton,-CA 95205-6232 <br /> Telephone:(209) 468-3420 Faz:(209) 464-0138 Web:www.sigov.ora/ehd <br /> �rFOR <br /> .FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 1, M Date: �_ Z�_ <br /> (74 <br /> Address: City: Zip Code: <br /> Owner/Operator, Telephone: <br /> Program Element, Program Record: Inspection Type: <br /> 8190 Posted Yes No Permit Posted Yes No . Re-Inspection on or After: <br /> 46dkRVATlUNS AND Ct7RRECTIVE I�CTlDi+{S - <br /> l <br /> / <br /> J <br /> 6 <br /> r <br /> f r <br /> 5 <br /> J y— t � <br /> •. - Item/Locattorl �' ' .�..r.Y. TernPeriiiure <br /> sFnod,Safetyre�t�f ationx`y `, Facllrtr Hot Water:Terr�perature � ' Warevrasfifn9° p,¢ <br /> _..-- <br /> Name: Hand Sink: of Chlorine: Ppm Heat: of <br /> Exp.Date: , arewashing Sink: 'IF. Quat. Amm,: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: Time Out: Pag of 2 <br /> FHD 15.24 (2n°pg) 413113 1 �k7 FOOD PROGRAM OR CONTfNUATTION <br />