Laserfiche WebLink
.2 1 <br /> SAN .JOAQUIN COU Y <br /> _ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 '%FS}a,)lc;n { <br /> • �;.. �;;P• Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd 4— to v v''I 5 <br /> �IFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ro m , ! oI LacDate: P_ <br /> Address: D r W ckCity: < 1 _ Zip Code: <br /> Owner/Operator: J� f _ Telephone: 559 3'1 a--7a <br /> Program Element: (DOI l/6 a 2 Program Record: ite <br /> O D '7 O l ,32 Inspection Type: C n I <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: r I <br /> �11 __ OBSERVATIONS AND CORRECTIVE ACTIONS <br /> r 0 Vq CX i!'1 r.&Sfr00 r" S Yl0►hd-Weta <br /> -71ni e 4- 00 PP r . p 45 <br /> v oo 5 O►r8 Ylp 'hJr c5 » . SJrP r—k <br /> i.240 r 6-,W n.i n! lilao r fit'r► v_>*? r _ oz L" 4-e-- d� <br /> +o l Ss Pt L . Pa-46.P w ra rn ka t <br /> i' ✓� rm ,i-I—c_l rr7 �0 <br /> G h ci r ('0r7-1 <br /> . <br /> w r 19 Oct I l oll a. 6 K W W ah-ec-ile y- <br /> 14 Corn <br /> Item/Location Temperature Item/Location Temperature <br /> Y -e r 5 <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: H d$'nk: 3 S of Chlorine: m Heat: of <br /> Exp.Date: Sink: 1,3 of �Quat. Amm.: ppm Other: of <br /> Received By/Title: /. <br /> EH Specialist: 191 1„ _ Phone: <br /> Time in: ho Time Time Out: v O Page` of <br /> EHD 16-24 (2nd pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />