Laserfiche WebLink
SAN JOAQUIN COON, <br /> ENVIRONMENTAL 1-HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �a�•«o �;:P Telephone: (209) 468-3420 Fax:(209) 464-0136 Web:www.Sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: / Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: <br /> Telephone: <br /> Program Element: /,:;?3 Program Record: �.IJInspection Type: <br /> LL <br /> Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> !C}BSEf 1lATK?lI aR1 ©„C@RF ECTlVl A <br /> - - _----- <br /> � - r <br /> --. f._.__.Csl <br /> It ocat>c�n � ernperature s_, hem,l Location ---.. � T�'R?rature <br /> Fa�ad';3a#ety;Ger3ific�ion Faciiity <br /> UWTemperature„ Vllarewa5hing <br /> �zW <br /> Name: Hand Sink: aFChlorine: ppm Heat: -F <br /> Exp_Date; Warewashing Sink: aF Quat.Amm.: ppm Other: _ -F <br /> Received By! <br /> — — <br /> EH$peciai t: Phon • <br /> f,me in: Time OuPag 150"r-1 <br /> EHD 16-24 I2^ pg} 413113 FOOD PROGRAM OR CONTINUATION <br />