Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> �o •c°a <br /> 2: ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: :< <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �q. - �`P•. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> �i FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: j, <br /> Address: - O� ( O City: stood"—)", Zip Code: q G,7Gb <br /> Owner/Operator: J Telephone: <br /> Program Element: Program Record: ta-, /; (0I 0?)':- Inspection Type: }t� <br /> SB 880 Posted Yes No Permit Posted Yes '� No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> -- v i of Cad cros Coi�e ay U-1pl ---— - - <br /> I (N ; Ca OAJV rll nctU qt rCj S <br /> 00'(.� S 12 Q s %W - <br /> C) W Ck -1- 6 1-aaEb Mq r <br /> )e oncl oks <br /> -�� Cit G�v,� t U S <br /> j n i ncj- C bj. <br /> tv W,V?e O G\ <br /> Item/Location Temperature ` Item/Location Temperature <br /> Food Safety Certification Facility Hof Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm (Heat: <br /> Exp.Date: Warewashing Sink: _F Quat.—Am m.—: PPM Other: <br /> Received By/Title: <br /> EH Specialist: Phone: _ <br /> Time in:Q_ Time Out: (�: Pag of <br /> i—, <br /> EHD 16-24 (2°pg) 413/13 FOOD PROGRAM OR CONTINI <br />