Laserfiche WebLink
SAN JOAQUIN COUN' <br /> �+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sogov.org/ehd <br /> <<FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ). 4?Cj Date: El it As' <br /> Address: / vYn "m �� City: Zip Code: <br /> Owner/Operator:/ C �, 7 tyt 'l0 Telephone: <br /> Program Element: Program Record: O �IS(l/ Inspection Type: r� <br /> B180 Posted / es D Rermit Posted Yes E I Re-Inspection on or After: <br /> Y <br /> 04,C � D�-Q,�i � �✓tti�vwC� <br /> orM Yv`t <br /> v� f l V I P <br /> Lc a (4-IJ14-i ALA <br /> d ti�c� k c,- arc <br /> v►.�tt - pol SD r,2 - <br /> 1Ov 1212 W_ <br /> ,la y �vrc�vL z <br /> w <br /> A _7 Yidt✓r d'� c�►�-est �,,,+� -- <br /> 4 <br /> " Item/Location Temperature it Item Location Temperature <br /> �'v���� ��',�--.6 Yom. U � �xG A •t,. � �:-�.�,�� ,. - �- <br /> IUJ �'x <br /> a4 -X� OF Ij-&I dr <br /> s cation Y. <br /> Warewasing <br /> Name, ..-. <br /> �a a <br /> A _( 1�`� Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: /L �G' arewashing Sink: of Quat.Ahmm.: Ppm tey: of <br /> Received By/Title: , <br /> �. <br /> OC <br /> EH Specialist: Phone: — ly� <br /> Time in: Time Out: O Page-�of <br /> EHD 16-24(211 pg) 4/3/13 FOOD PROGRAM ORCONTINUATION <br />