Laserfiche WebLink
aur" SAN JOAQUIN COUP <br /> 4 xa 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 /> L�FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: City: Zip Code: <br /> All <br /> Owner/Operator: Telephone: <br /> Program Element: P ogram Record: Inspection Type:/09 <br /> SB180 Posted Yes No Permit Posted Yes No Re-inspection on or After: <br /> OBSERVATI© ANIS C�RRECTIV ►� <br /> T.w V iC <br /> --(D _............... �_[Ll _— ��Yi �/,/ ��/�/�c�/moi U/�/ x�'�7' C�,«//.. .........................-- -- <br /> ........... ........_.......... -_ - -_...-- ---- ................_..........-.-.-................_....._....................... --- _ - -- <br /> .............. <br /> O17-/ <br /> ... _........-.....--.......... - -- — - ............ —---- -- .................... ..._._. <br /> -_._......--_–_G 'L---------- . ......._ ._..__.fl CP ' <br /> Ile <br /> s / <br /> Item/Location ter-Temperature �` item/Location Temperature <br /> 0 <br /> _ �25 --------- - o S� <br /> Food_Safety,Certification Facility Hat Water Temperature Warewashmg = , <br /> Name: Hand Sink: �j� of Chlorine: ppm Heat: -F <br /> Exp.Date: �Q/ arewashing Sink: �a79 of Quat.Amm.: ppm Other: of <br /> Received By/Title <br /> EH Specialist: Phon i:a <br /> Time in: �J Time Out: /a Pa g of <br /> EHD 16-24(2^d pg) 413113 FOOD PROGRAM OIR CONTINUA <br />