Laserfiche WebLink
SAN JOAQUIN COU t <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> H: :< <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.or /q ehd <br /> �rFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: O 0 5,tq Yn6l►'i,,t 1.1 Date: 1- 20-15- <br /> Address: <br /> Q_/5- <br /> Address: I 3 /J b ,O�1 + City: C+O C �r) Zip Code: 016 <br /> 2O <br /> Owner/Operator: b I e Q c� Telephone: jq8_,?76 �L- <br /> Program Element: I(D Zg Program Record: P (ZI') !J a O ( Inspection Type: �� n <br /> SB180 Posted Yes No Permit Posted XYes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> —— -- -- - tom- _._ ....... ._....... _ <br /> � � u a e►-- tv of lgo Mm e h . 5►'�-e L)- <br /> rne�.i� <br /> Item/Location A Temperature Item/Location _ Tempera�tire <br /> Food.Safety Certification Facility Hot Water Temperature ( Warewashmg <br /> Name: - 'Hand Sink: Chlorine: Heat:V-71 t ppm of <br /> -- ---- . <br /> Exp.Date: o, are hing Sink: J of I ?19DQuat.Amm.: ppm ilOther: of <br /> Received By/Title: <br /> EH Specialist: �^ 1,. L Phone: �L 3_ rt b )•� <br /> ime in: Time Out: '3 Page of <br /> EHD 16-24 (2n°pg) 4,3113 FOOD PROGRAM OIR CONTINUATION <br />