Laserfiche WebLink
�o?ate coG SAN JOAQUIN COUP ' <br /> a ENVIRONMENTAL HEALTH DEPARTMENT <br /> --_ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: J h n R, V Y a Date: 3-4, -16 <br /> Address: -Z 4 60 (Y _ -GLO � PrVe City: � � n Zip Code: <br /> Owner/Operator: l..t,.�e D � Telephone: at <br /> Program Element: 2 Program Record: P (b 0X3-7 Inspection Type;,,,a tkr.K f'L2. <br /> SB180 Posted 7Yes No Permit PostedYes No Re-Inspection on or After: <br /> ;. . C?BSER1lATIUNS��1N©C©RRECTIV :ACI�ONS. n <br /> _ e <br /> _4%+_ -em+r wnr-¢ I.e_larrn LAJa,4-e r Q'S'F - <br /> --- ✓t Gr e a k-- -- - I DO-l 0�3 of 3l ce l l s <br /> a � �- '� em `' item I.t_ocatwn 'tl� Temperature. <br /> _GUD Ce P-_ ryja -""e e <br /> r G c1 P►- �L�r .�� F �- b� <br /> -- <br /> co,o <br /> Food Sa#E £ertifcatton Fac'ii Hot Water,Tem rature_ Warelnrashing <br /> ty <br /> Name: a0mAr Hand Sink: ,� .O of Chlorine: Ppm Heat: of <br /> Exp.Date: p` L _` O� arewa in i2� ;Z-6 -F Quat.Amm.: goo Ppm Other: o f <br /> Received By/Title: J <br /> EH Specialist: � Phone: _q 53����•� <br /> Time in: i ,y� Time Out: �� Paggef Z <br /> / <br /> EHD 1624 (2n1 pg) 413113 FOOD PROGRAM OR CONTINUATION <br />