Laserfiche WebLink
f <br /> L <br /> o akl.y SAN JOAQUIN COUNTY <br /> ?� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 �D' <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 web:www.slgov.org/eh <br /> {fFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: 12?�} -Z� City: Zip Code: 53�f0 <br /> –� <br /> Owner/Operator: t �,� Telephone: Z4� <br /> Program Element: 2J Program Record: Inspection Type: j <br /> �A <br /> SB180 Posted ❑Yes ❑ Rermit Posted ❑Yes ❑ 1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE:ACTIONS <br /> z—+— b ` <br /> n - -- - <br /> 1 � <br /> To-Ic -A� a <br /> `/} f}`.�1?--( *-- .-Q... L1-'�"Un"-`WC-7- <br /> fC� tr�o _,_.� ��: O•c 2- �-�� 1klrsre� ����.. r ,�n <br /> C.icy-C- c J. <br /> ItemlL.ocation 'Temperatui°e 7 C ocatlon Temperature <br /> .._ r ...w 2-TEMP TNER � } <br /> MOL4'vL g <br /> 160°F 1 X <br /> v -- Square turns 7Vc — - <br /> 1 black as P t <br /> .temperature 17I� <br /> 1s reached 77'C C <br /> 82°C <br /> Food Safety Certification Facility Hot:Watar Temperature. Warewash9ng <br /> Name: Hand Sink o Chlorine: Heat: <br /> _ �O. eC� Cir�'-✓�._ __ F ppm i F <br /> Exp-Date: arewashing Sink: t2 of Quat.Amm.: PPm Other: of <br /> Received By/Title: X55 I CA- <br /> EH Specialist: – — - --- - Phone: <br /> time in. i Time Out: 1 11: Page of <br /> G <br /> EHD 16-24 (21 pg) 4/3113 ���� �� �.� FOOD PROGRAM OR CONTINUATION <br />