Laserfiche WebLink
SAN JOAQUIN COLIN' <br /> 0: X <br /> 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 /> �/FORt•� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Gc ,S ' S Gu Fa n t Date: X12-.ra-/ 1 <br /> ddress: 14 0 t �Ao d I n City: Zip Code: C,159-10 4 <br /> Owner/Operator: % I U2,1 J wt— Telephone: <br /> Program Element: 1 b2t� Program Record: t R U 1 ( En15- 00003Cj 4 10 Inspection Type: CUv 00 1 n <br /> Fffi8O Posted ❑Yes ❑ Rermit Posted ❑Yes III Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> ccs 1 infi sic ar wP/hs ard 6i f-t on L.� k ip <br /> -f- Le S C,A- 11 \�&r f TP-� V-0old <br /> Iw O-T)d . -mJ i n a rd <br /> n- <br /> -} Uc(� r YO1 tord Ove <br /> TtC, �J U1� CA c+ <br /> CAeo <br /> to U vel uN e \o* o <br /> Item/Location Tempera �,o 9�et r,T rn ra <br /> . f G t bfty •�Aa � Facility Hot Water Temperature Warewashing <br /> M.y ...__. <br /> Name: Hand Sink: of chlorine: ppm iHeat: of <br /> Exp. C-, 9 of ppm Other: of <br /> Ex Date:. ar�washin Sink: Quat.Amm.: <br /> Received By/Title: <br /> EH Specialist: Phone: 71 <br /> Time in: G 5 Time Out: I ,� Page 'of <br /> EHD 16-24 (2n1 pg) 4/3/13 1 FOOD PROGRAM OIR CONTINUATION <br />