Laserfiche WebLink
PQu�" SAN JOAQUIN COOTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.slgov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: P Date: 1677-111!K <br /> Address: /?! 7� City: Zip Code: <br /> Owner/Operator: Telephone: —Q <br /> Program Element: l� Program Record: U Inspection Type: <br /> SB180 Posted Yes ❑ No 1 Permit Posted 1 Yes No Re-Inspection on or After: <br /> _r <br /> r OBSERVATIONS AND CORRECTIVE ACTIONS <br /> J <br /> vvvt,f aW JT7-m <br /> Item/Location Temperature Item/Location 1 Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: °F <br /> Exp.Date: Warewashing Sink: of Ouat.Amm.: Ppm Other: F <br /> Received By/Title: <br /> EH Specialist: Phone: LI& <br /> _ f% <br /> Time in: /l �S Time Out: a Page of <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />