Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> '+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �;.: ..,..•;P. Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> �%FORS <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Z u /l I ✓i / 5 S Date: <br /> Address: � �1 5.6 City: �ti� Zip Code: <br /> 1� 9y5;7z <br /> U W. t!� �. / �r <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> N <br /> SBI 80 Posted ❑Yes ❑ No Permit Posted ❑ Yes ❑ No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> LAI -(4 a,n 4 ')00.'j re 'aP r htivr C/nd On +�- <br /> MAJ } h . <br /> �1 (1 <br /> 3 u IA'. d - V O ve 3-, + re go i-,w 4c A C r s s -P,a nY% -I r <br /> Q 4 o dqy <br /> Cover circ 2- <br /> 4 : Irs4 ; 1? '5 <br /> I; Ay P e s net ale j2� <br /> I Z, r r hus a ala rY7 O'E'.r/ <br /> 11. P i rn 2 VW o o lei <br /> q-d Gorr t I <br /> Name: p rHandink: /0rofChlorine: ppmHeat: o f <br /> ef Exp.Date: ashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: .y2 Time Out: QO�S b Page, of - <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />