Laserfiche WebLink
SAN JOAQUIN COUN' <br /> .z ENVIRONMENTAL HEALTH DEPARTMENT <br /> - _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �q•.., N;P Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.or /q ehd <br /> L�FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ' 1 11S16,-A z Date: 1 —2 I <br /> Address: City: G - G-o Zip Code: q 2 <br /> Owner/Operator: n C J Telephone: 9 S2 0 2- <br /> Program Element: �� S Programecordeei <br /> �S 2 3--7 Inspection Type: <br /> SB180 Posted es No Permit PostedNo Re-Inspection on or After: �1 <br /> OBSERVATIONS AND CORRECTIVE,ACTIONS <br /> -- __ hG—z a•�d�-owe s�n�s�-� � ��,: r�-�a`-;�-�Ql <br /> ---------- <br /> 3 <br /> C <br /> _ A- <br /> \7:C e e - <br /> QQ <br /> Item/Location ?emperature Item/Location Temperature <br /> 1-4 OF- <br /> -- <br /> Food Safety Certification ing <br /> Name: N\ Hand Sink: `O2� OFChlorine: 2cyo ppm Heat: . OF <br /> Exp.Date: washing Sink: 12 of Ouat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: - Phone: <br /> Time in: Time Out: JJ Page, <br /> '\ Zf <br /> 2 <br /> EHD 16.24 (2^"pg) 4/3!13 FOOD PROGRAM OR CONTINUATION <br />