Laserfiche WebLink
SAN JOAQUIN COUP <br /> '•OG <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siQov.orq/ehd <br /> �IFORl� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: CC Date:c,!' �l n <br /> Address: jrC� {� / r v City: `, Zip Code: <br /> ,. <br /> Owner/Operator: — .� t Ji G H z I a r W. Telephone: <br /> Program Element: , CG,) Program Record: C0 C., _3 y 7 6 Inspection Type: D <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> Cc 1A . Ia k a a6If5 h SerV It C <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: Yll, <br /> Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Titt, <br /> EH Specialist: Phone: J/1/� <br /> 4( [7 <br /> Time in: /Z Time Out: Z,x Page of <br /> EHD 16-24 (2n1 pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />