Laserfiche WebLink
SAN JOAQUIN COUNT' <br /> 4 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 /> •4L j f O,n to <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: Qb y�A City: Zip Code: <br /> Owner/Operator: I&T' Telephone: <br /> Program Element: (y Program Record: �a Inspection Type: !l ai v -1 <br /> SB180 Posted es No <br /> No Permit Posted Yes No Re-Inspection on or After: l J <br /> OBSERVATIONS AND CCORRECTIVE;ACTIONS <br /> ✓ta _.._.- <br /> -- . . _.................— <br /> 14 <br /> U 4W <br /> GL <br /> Lt _ <br /> --...--.......... ---.........................._..._......... <br /> _ <br /> Item/Location Temperature Item/Location Temperature <br /> AA <br /> ,l a <br /> IJ <br /> Food Safety Certification Facility Hot water Temperature 1Narewashing <br /> Name: Hand Sink: of Plorine. ppm Heat: -F <br /> Exp.Date: arewashing Sink: © of Quat.Amm.: ppm Other: -F <br /> Received By/Title: <br /> EH Specialist: i Phone: _ <br /> Time in: Time Out: t Page of <br /> f, <br /> EHD 16-24 (2^'pg) 4013 FOOD PROGRAM OIR CONTINUATION <br />