Laserfiche WebLink
aPa!flN. c SAN JOAQUIN COUO <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax.(209)464-0138 Web:www.s'gov.org/ehd <br /> 441 PORE` <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: W 1-lU C r- w-a mama Date: 2-A'/ 1-+ <br /> Address: + -t-�.,-,- City: S C� zip Code: P D fj <br /> Owner/Operator: C Gt f los V e_ LG p ,V' ,.Q Telephone:2Cj b-21`!2 <br /> Program Element: (�3 Program Record: 1 RU --)C) 1�2-V Inspection Type:L�u_ �,l_lnQ <br /> B180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: 1 <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> l <br /> M0 to VOC <br /> —A S oh iWt W-n'S CCAVA-1 v A T-Q <br /> Tl�fi h`C �TFct7m i- MG11 <br /> q 1 t i �_ NA can - MQ IR_161 n <br /> n 1 me r <br /> Food Safety Certification Facility Hot Water Temperature ( Warewashing <br /> Name Hand Sink: <:F Chlonne: ppm Heat: �F <br /> Exp.Date: arewashing Sink: eF Ouat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> ime in: l o t� Time Out: 0 . Page f <br /> V <br /> EHD 16-24 (2b pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />