Laserfiche WebLink
PQu�" SAN JOAQUIN COU <br /> 2+ 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 /> �IFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: o-C�v- t*i (6a x Date: y _a_I <br /> Address: t6wi Pa" G Ave- City: -ton Zip Code: 5�-0 <br /> Owner/Operator: Arl,� L oada Lr Telephone: X925 ` <br /> Program Element: 1 b 214 Program Record: Pa 01(o O L41 <br /> Inspection Type: t'A- <br /> 8180 Posted El Yes ❑ Rermit Posted r ❑Yes ❑1 Re-Inspection on or After: <br /> "l -k 1vJ ats l-t r5 so r A,A-f-Lt P- V-eJ� c:b ?� <br /> h V o 0,0 m h e- - �C 1 V�� Cly" n v, <br /> C.tAb CA _+i ze r <br /> 1 u1 Q r� -e5 )' l.t�q-}C Y �'�-¢_ o Q�Y10 <br /> u1 L * M� Y oc:i r w -1-t >r ...Q .-e.- 6 e h n.1 to k d+ <br /> L; r-e-- l u-� r <br /> rfl w4- <br /> �IoL\A�2 Un Sy,n.► i-"r S Q C_e y 1>f_ C-A { <br /> jZ e s tr +p V.Lk clr 5 ,ZP�r�s a r5 5 li UA civ r'jc- w o�- j2�� lc� <br /> 6o Yy%e t- 14m,.d a v-e- 0 r-e Sj cA,2 . <br /> +Z> cl.c }�-t 1 Ll V C, r, e� o, ra-�-�- ►�-�_ I��c ; <br /> v V 1 ® tA+� on s c.c J is t Y'i —1 -iS LAJ-e.r-e- Co r r-e c+4e,/ . <br /> 271 + , <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: �W, f_ / Phone: <br /> Time in: /0"'; <br /> , Time Out: Page,of <br /> EHD 16-24 (2n1 pg) 413/13 FOOD PROGRAM OIR CONTINUATION <br />