Laserfiche WebLink
aQul" SAN JOAQUIN COUNT <br /> .pa ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> LIFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Yv1 vwvt )'1 V' Date: <br /> Address: / City: Zip Code: <br /> Owner/Operator: ( V� u' y r— Telephone: 1-7 _30 <br /> Program Element: l n ( Prog am Record: iry x t2� Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> ot, o(Gltic ovvt / <br /> A�Ad& Ate nol- M�;� <br /> v � 1114 c4n A <br /> V-\, A61 .Q oto 10 3 /WuA4-t <br /> Item/Location , Temperature Item 1 Location 1 Temperature <br /> ti ,ti tiJ /L� rk i y4 <br /> L 2 I - <br /> ` �� <br /> C <br /> —Food Safety <br /> �1 k t-l: 1 <br /> G ,'vL—�,t i' , 's 1' <br /> y Certif cation Facility Hot Water Temperature Warewashing <br /> Name: (,L )t,Vl dd Hand Sink: 5' `F Chlorine: ppm Neat: F <br /> Exp.Date: arewashing Sink: i yf -F Quat.Amm.: ppm Other: of <br /> Received By/Title: �/►- _ <br /> EH Specialist: 1� Phone: <br /> ---------. - — a <br /> Time in: Time Out: 5 Page 2Df <br /> • 6 <br /> EHD 16-24 (2n0 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />