Laserfiche WebLink
SAN JOAQUIN CC 'TY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.slgov.org/ehd <br /> LIFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: u' Date: <br /> Address 1 N rn (`1 City: i y� Zip Code: <br /> Owner/Operator: ( !.� ns}— 0A11 k7l"- L �N, n C Telephone: <br /> Program Element: J Program Record: O � !q Inspection Type: ��/ r1 <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: �G <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> ( .. �% L U� -eel)92e <br /> � h • <br /> Ittt1�C s ltet»" tract�ollt as <br /> Name: n Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: ! �� of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: yy� /✓ Phone: -- <br /> Time in: , , ` Time Out: ( Page ?f <br /> EHD 16-24 (2n1 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />