Laserfiche WebLink
SAN JOAQUIN COL 'Y <br /> � •.pG <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.or /q ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: I /C <br /> CG V <br /> Address: J ' City: / Zip Code: <br /> Aj <br /> t; <br /> u <br /> Owner/Operator: e0v Telephone: <br /> Program Element: Program Record: �l, Inspection Type:./1 <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> _— �vr�l-ry�.1,—.. ��iTi Y1^ -+- L Gy�,r,�'ivY� 1• -� <br /> /u <br /> -- _ -- <br /> 8wt c a A% wu �G�rGC( <br /> �� oLrR <br /> j7 if JAA <br /> _......... <br /> ---- <br /> Dow AA&W of <br /> as <br /> 3 Cooney) <br /> W'w" - <br /> o "Om it wul <br /> ItemlLOcation Temper tore Item/Locatwnu Temperature <br /> qF <br /> aw <br /> Name: Hand Sink: OF hlorine: ppm Heat: OF <br /> Exp.Date: Warewashing Sink: of uat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: Time Out: 2- Pagly, <br /> EHD 16-24 (2�pg) 4/3!13 FOOD PROGRAM OR CONTINUATION <br />