Laserfiche WebLink
PQu�" SAN JOAQUIN COU10 <br /> �o . .......o <br /> TF <br /> 'X ENVIRONMENTAL HEALTH DEPARTMENT <br /> •'•. _ = 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.or9/ehd <br /> 9�lFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> c�n-E - <br /> ddress: City: Zip Code: <br /> Owner/Operator: -r0 Ks4,o S4zn r <br /> /+ _r Telephone: _ �s <br /> Program Element: 1 Ofl Program Record: Inspection Type: <br /> SB180 Posted ❑Yes 7 Permit Posted C Yes Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> o d ., _ �►-L }-r'ou lie r i.►-� �cL Cl- 0--E -,fir c.� ( � <br /> s b <br /> 0 k) M CIL011110s <br /> L20 0 -f5`I <br /> r01 n+ d,t_)rrL st-e r <br /> IF <br /> D 6serva.-I-ia� ,_,�r L-s ° CA <br /> r -► -- Qs (-2 LP4 ro car►d 14 JA <br /> ro v" trte..( Q r I'd n-a -- r <br /> i2py-re-c4i6n H-q\le- W0544 YYL-PA nA -kX <br /> ,r &I-) ro 64- -4k.-a- 1 4 <br /> I -!- -e o o ay d OLO ri a r <br /> &71 Lj Ott_ i S <br /> o d.drs . 04n rre_e_-+ __ low► <br /> Item/Location 1 Temperatur8' '> v.. f Location I Temperature <br /> - I <br /> ---_..... - ` <br /> F Safety Certificatio I Facility Hot Water Temperature W, rH <br /> ng <br /> Name: iHand Sink: of Chlorine: ppmat: of <br /> Exp.Date: Warewashing Sink: of uat.Am m.: ppm ther: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> ime in: Time Out: 0 Page' of <br /> EHD 1624 (2n1 pg) 4/3/13 J FOOD PROGRAM OR CONTINUATION <br />