Laserfiche WebLink
�P411N SAN JOAQUIN COL 'Y <br /> �.•' A� <br /> 'a ENVIRONMENTAL HEALTH DEPARTMENT <br /> -_-_ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �q..• �;;P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sugov.org/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: zk Y- 6r i t ) Date: -('9-1 <br /> Li <br /> Address: fo 1 O N orad-o City: Zip Code: <br /> Owner/Operator: ` Telephone: -,�,a '7_qr1 <br /> Program Element: ! ('0 7Lj Program Record: .� R � 'to28 5-3 <br /> Inspection Type: <br /> L!2!sted Yyes No Permit Posted '>Oes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> f Q " CZV to Q— Jaeln..i r,c c; mcn+ i�,6 yj <br /> n -tv lu <br /> r y- 41-C 12 erl t:� -- <br /> YYta 4f <br /> o +-C U IF p <br /> Item/Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: 'Florine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of uat.Am ppm Other: of <br /> Received By/Title: <br /> i <br /> EH Specialist: /��N ,2 ) Phone: 0253 <br /> 7 2 )7 <br /> Time in: i I. Time Out: `:3 0 Page of <br /> EHD 16-24 (2nd pg) 413/13 FOOD PROGRAM OIR CONTINUATION <br />