Laserfiche WebLink
SAN JOAQUIN COUr <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 4 W <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sogov.org/��e� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: ra y City: Zip Code: <br /> Owner/Operator: Telephone: -- <br /> Program Element: Program Record: ��( I Inspection Type: <br /> B180 Posted Yes ❑ Permit Posted ` es [❑I Re-Inspection on or After: <br /> '01y $ �� <br /> ;.. <br /> MIL m i <br /> rr <br /> Cc ', <br /> _ , <br /> 7r U <br /> r r <br /> r <br /> u C O 1 <br /> 1 o f r r 1 <br /> .e UP •t"mr _� �, b . ren -- <br /> Mop SVS <br /> •� . : •.? ,., ��I �.; ` �t�peratu :' <br /> 'r- 3 <br /> ►n <br /> r tie O <br /> Name: `ry � ,rye <br /> and Sink: P I� ofChlorine: ppm Heat: of <br /> Exp.Date: [ �Z�V arewashing Sink: l 'F Quat.Amm.: ppm Other: 'F <br /> Received By 1 Titl . <br /> EH Specialist: ,Q,/t Phone: <br /> ime in: I (f' t' Time Out: Page of <br /> EHD 16-24 (2n1 pg) 413113 FOOD PROGRAM OR CONTINUATION <br />