Laserfiche WebLink
SAN JOAQUIN COU[ <br /> Z+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: A Date: ;z- - 5 <br /> ddress: 024% City: 6,70 4D <br /> ri Zip Code: 9,52-07 <br /> Owner/Operator: 'J�� G �Q bo �n c_�,7D - �� Telephone: � ^09Z <br /> Program Element: 1(02-44 Program Reco : P Q O I(o D $ q'O Inspection Type: P-LI k-L3 <br /> 6180 Posted ❑Yes ❑ Rermit Posted E Yes ❑ I Re-Inspection on or After: <br /> -e V JI nor I o rLAe- .e 5 5 ot-4-e -e r Uj <br /> Ln�$ . <br /> i t—o o _ <br /> '-pro 8 I Y» a-►-e <br /> r <br /> Viz, �`: y.: � �� ��`Mf• � '��^` <br /> Name: ' } Hand Sink: 'F Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: of Quat.Amm.: ppm ther: of <br /> 2- 2_0D <br /> ppm <br /> By!Title: <br /> EH Specialist: y /Phone: , 3 <br /> Time in: I j Time Out: i i �! d Page,,of r <br /> EHD 116-24 (2n1 pg) 4113 13 FOOD PROGRAM OIR CONTINUATION <br />