Laserfiche WebLink
, C <br /> } <br /> 600 gas I , <br /> �..•� Tele hone: 209 468-3420 Fax: 209 f <br /> �rFaa A ) ( )464-0938- e <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: qq Date: Jr <br /> ddress: U City: Zip Code: <br /> caner/Operator: ITb <br /> ub ne: <br /> `7 y <br /> Program Element: Prog am Record: Ins ection ype 0o <br /> f , <br /> i B180 Posted ©Yes fl No Permit Posted 0 Yes O No Re-inspection on or After: <br /> wo <br /> 6 <br /> 01 <br /> APINW104,11- At", <br /> f <br /> 1 f <br /> t +s <br /> R, R . *90.4 k3e ;,.� t 9a� a 7'; It@Irr 1 Y81r1'p813tUr4 <br /> Galtificatton� hh`s, ��' 6•:� I'`. ltd e #'�;�. ""``a b "'.a am<y,,wdF@1hfa�Slii.11 v. ?r <br /> Name: Hand Sink: aFChlorine: ppm Heat: -F <br /> Exp.Date: Warewashing Sink: 'F Quat.Amm.: ppm Other: `F <br /> Received By 1 Title: <br /> EH Specialist: Phon • '. 0- <br /> Time in: , Time ut: Page'of 1 <br /> c <br /> [HO 16-23 (2"dpg) 11106108 FOOD OR CONTINUATI <br /> t:� <br />