Laserfiche WebLink
PQutN SAN JOAQUIN COU t <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.orq/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: / <br /> � !�/�� Gl"� l �� i 41 Date: <br /> Address: J� ��� / City: fj Zip Code: <br /> Owner/Operator: IVO ! / r L j„_ /G jj Telephone: <br /> Program Element: <br /> d/vl I T Prog Record: G.` G(/ Inspection Type� '�-,ktic <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or Aft&: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> c1'/r! Co Gr <br /> J <br /> c / <br /> lie A 49 te 4-v va re n <br /> d Gt r a � Wake- <br /> til a I r <br /> 4n usu ✓✓"t Ce ml /%e <br /> V -e v1 <br /> also _nnayutua c l aG I, <br /> 13S2- eo6q 3 <br /> TLg <br /> Item/Location Temperature Itemt acatlonTemperature <br /> n Q <br /> h ! d <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name:— <br /> ame:Hand Sink: — of Chlorine: PPM Heat: F <br /> Exp.Date: ewashing Sink: of Ouat. mm.: PPM Other: of <br /> Received By/Title: <br /> EH Specialist: rw I wIf Phone: " <br /> Time in: Time Out: Pag of <br /> EHD 16.24 (214 pg)4/3/13 FOOD PROGRAM OIR CONTINUATION <br />