Laserfiche WebLink
SAN JOAQUIN COU Y <br /> P <br /> 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 /> L�FORN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: (�-(,\Jt >V✓�2� �� - Date: r <br /> Address: /1 u City: ti Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: t Program Record: D Inspection Type (" <br /> SB180 Posted Yes No Permit Poste Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE! G <br /> P' /Y�V...............1.__ <br /> Iowa Cl� tiw <br /> , <br /> A 14 <br /> G '� Y ,0 W �- <br /> (iL•V 1,V(• Itern/Lo�tiDn �t�l���� �' T erature 0�r <br /> —� ��— P <br /> j� _ P— ���— - — —rnper ne <br /> Item/Location r2M Te ti <br /> a <br /> — - <br /> q 14 io <br /> Facility Not Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm (Heat: :F <br /> — - -- _ <br /> Exp.Date: �D �OGI arewashing Sink: of Ouat.Amm•: ppm Other: of <br /> Received ByITitle: <br /> — s <br /> EH Specialist: Phone: <br /> Time in: Time Out: Page"tof <br /> EHD 16-24 (2nd pg) 413/13 FOOD PROGRAM OIR CONTINUATION <br />