Laserfiche WebLink
SAN JOAQUIN COUI <br /> .Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> -_ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s'gov.org/ehd <br /> �IPORN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: (/C)/'2 711 <br /> Address: � � City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: /i' Inspection Type: <br /> SB180 Poste6K <br /> Yes No Permit Posted' Yes No Re-Inspection on or After: <br /> ' OBSERVATIONS AND CORRECTIVE ACTIONS: <br /> 3 U a 16� 'A A421ed A44 <br /> �n 2 - kwu wfL d <br /> I Md vvi <br /> Item/Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: j 'F Chlorine: ppm Heat: °F <br /> Exp.Date: Warewashing Sink: of Ouat.Amm.: ppm ther: �F <br /> Received By/Title: <br /> EH Specialist: Phone: 4 <br /> Time in: Time Out: ( Pagelof'L <br /> C. <br /> EHD 16-24 (2n1 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />