Laserfiche WebLink
°adSAN JOAQUIN COL Y <br /> ioe <br /> y x ENVIRONMENTAL HEALTH DEPARTMENT <br /> Y. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.orq/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: <_4,on or+s Date: yr -_2 <br /> Address: q0 y Li :FK,-e-yYLp nT I �+ City: 64-o -t-on y <br /> Zip Code: ! 7- � <br /> Owner/Operator: D L)a 4i vn �, rll i K-.L- 607" 50G/ P <br /> 7 Telephone: 6 97 <br /> 0-7-50 <br /> Program Element: 4a r; <br /> rogram ecord: •n`J .l O y7/�� 141 /L 1 Inspection Type: '` V r <br /> 8180 Posted Fj Yes 0 Rermit Posted ❑Yes ❑t Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> P tP 0 9 ('0 <br /> 1 O-f-t lr l 2-d6 F <br /> W a 115 1rYLo S*,--)L we v-,-- r-e ct.i "e-C4 - <br /> PIS O 5 2-&0 ! I 6 CL e,lc: Po rC-1-1 <br /> i •.i r Uln v n• W ryl <br /> CO1.1 L i'�tJ I lc✓ <br /> (RO5 r p <br /> lam + wla my r i 2-OT <br /> L4 Y <br /> PR D 5 D CA ry <br /> a-t c,i llr.s ' •" rkSssiz O U t-e- r <br /> (ll�4l �I S a-}- YWOS 1 -4L W-t r,e <br /> Item/Location Temperature item!Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: — ,^/� 1, „ <br /> EH Specialist: t_ _ C. + R� Phone: � 6 3 ` 8 0 <br /> Time in: �(/1•'! Time Out: _! Page tof <br /> 40 <br /> EHD 16-24 (21d pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />