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I <br /> oP°`liK• c SAN JoAQUIN CouLir <br /> a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> . .. ;�• Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> oc��oA"i <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: He�nch4l`p 8a ran Date: <br /> ddress: / / J� City: C5� - Zip Code: <br /> 'T <br /> 26 <br /> Owner/Operator: Telephone: _ 9;26 7 <br /> Program Element: Program Record: Q �!/_ Inspection Type: <br /> 180 Po <br /> 8sted Yes 0 Rermit Posted r Yees 0 1 Re-Inspection on or After: <br /> K .... <br /> . 3 <br /> 90 N <br /> ... ... <br /> l �TYt1L 1 cloor- co r i,,t i J1 rr Yl a 6 <br /> I'F or Lo W4, r <br /> d r ci_* r� e <br /> Co P1 >'t4k.e_ eti n--!tiro <br /> ri o b r2k'o rsn r - °S-,P- CA-g s <br /> m ea: ii JR4 t2 el-A <br /> LA <br /> h u aM 1,0 a4f- r b ki 6 re; CID LO <br /> a.cr Va-tU-e_ a- <br /> C r 4- Cyl-e ba e� - <br /> b w <br /> ct- — �rr <br /> Y dl d l�P.. l>~ <br /> ZI <br /> (:fir-f-S c��5 a, �. ice► I�c�C.e d � (°}�v.>? -I-l..t m �`' i� _r�E-�r t.-� <br /> BeL cK - �c1 0 �-w Q S <br /> _�... m <br /> o <br /> ca.00,r rLl l n <br /> ------ -------------------- --- -��' - <br /> c.� ►-- Sct °a q° <br /> I C60Y s <br /> m <br /> v � .. rMan <br /> y <br /> Name: Hand Sink: of 7thlorine: CID ppm Heat: of <br /> Exp.Date: arewashing Sink: -F Amm.:� ppm Other: -F <br /> Received By!Title: '►,�a { bot rd4 u 5hn <br /> EH Specialist: Phone: %L5 <br /> Time in: rif: Time Out: 4O, 1 1 Page of�Z <br /> EHD 16-24 (211 pg) 4013 FOOD PROGRAM OIR CONTINUATION <br />