Laserfiche WebLink
SAN JOAQUIN COUI. t <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> . c... ;p• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sugov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: '— r Date: ' , 1 <br /> C �,r ! c, <br /> Address: }►� City -�-r4; Zip Code: n s j <br /> Owner/Operator: n . I �?` �, r V� L Telephone: 73- 3 3 y 3 <br /> Program Element: Program Record: W ti Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> T r? l <br /> �� a OBSERVATIONS AND CORRECTIVE ACTIONS <br /> _. <br /> ,So 161 11011 G rP 4e (? X C ,' .) — <br /> 1 n re n &j tl,,n C J;cam , <br /> a,r U)C , / <br /> a V + 411 Q C ugh � � u�C�� A ooa,, 'j UOCr cr <br /> R , ( act , r <br /> 0-+ -earl 16 0Ari3bro. #o% d. /r PS Itof <br /> V r G ri <br /> YI('j I n <br /> rPCP ; e - ' n - 4 � 1 <br /> "C (Ar. <br /> Item/Location Temperature Item/Location Temperature <br /> YUC <br /> Food Safety Certification Facility Hot Water Temperature Warewashi,ng <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp. Date: Warewashing Sink: of Ouat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: jx6 !i <br /> i y o O <br /> Time in: i Time Out: J 1'D Page of / <br /> EHD 16-24 (2"pg) 413/13 FOOD PROGRAM OIR CONTINUATION <br />