Laserfiche WebLink
p,°".�" SAN JOAQUIN COUN , r <br /> o .... ... c <br /> �.••�••.off <br /> X ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ - 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �4•..• Telephone: (209)468-3420 Fax: (209) 464-0138 Web:www.sagov.org/ehd <br /> L�FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: '- �- �� Date: <br /> Address: .2 22 2 City: Zip Code: <br /> o�G�- <br /> Owner/Operator: (1. ` _ 1 Telephone: 2 -j2_ 0 <br /> Program Element: •Z� Program Record: Inspection Type: <br /> IS6180 Posted ❑Yes ❑ Rermit Posted ❑Yes ❑V Re-inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> \ <br /> \ bi 1 e in(eJ <br /> C;. s . <br /> Item/Location Temperature Item 1 Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashmg <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: of uat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: V. 1I/_ V <br /> Time in: i 2 Time Out: 1 ,S Page of <br /> EHD 16-24 (2ndpg) 413/13 1 FOOD PROGRAM OIR CONTINUATION <br />