Laserfiche WebLink
P4"'" SAN JOAQUIN COUNTl <br /> O c <br /> Z-� ENVIRONMENTAL HEALTH DEPARTMENT <br /> X <br /> _ = 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �fFww <br /> cq...• ..a;P Telephone: (209) 468-3420 Fax: (209)464-0138 Web: w.sigov.orq/ehd <br /> OR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: &jLavY LDate: <br /> Address: City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: (�/ Program Rec d: O (/77 Inspection Type:�1 �.L, <br /> VB180 Posted es ❑ Rermit Posted es/❑1 Re-Inspection on or After:: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Y Item t Location ! Temperature <br /> Food Safety.Geril fication Faaff it, Hot Water Temperature Warewashing <br /> Name: � Hand Sink: of Chlorine: ppm Heat: `F <br /> 1. �'�'1✓l.f, <br /> Exp.Date: 4 arewashIng In of Quat.Amm.: ppm ther: °F <br /> IP <br /> Received By/Title: UIXA <br /> EH Specialist: Phone: <br /> Time in: Time Out: Pag7f <br /> EHD 16.24 (2n°pg) 4133/13 FOOD PROGRAM ORCONTINUATION <br />