Laserfiche WebLink
SAN JOAQUIN COUP <br /> .Z, ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • ,. : ;p Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> 4L�i=0Ra <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: �ur CLQ n- e 11( c 9 Date: <br /> Address: 2 5 e )\U1► + City: S.t�GLigm Zip Code: C1 52-b-4 <br /> Owner/Operator: `� MIn do-T S 1 ne!j-b �-I Telephone: q-A —4,q 2� <br /> Program Element: lip S Program Record: () 1 (0 ) ���G Inspection Type: F—CM-Ih R--- <br /> SB180 Poste Yes No Permit Posted Yes No Re-Inspection on or After: <br /> ACTIONS- <br /> OBSERVATIONS <br /> AND CORRECTIVE ACTIONS <br /> 3 r t <br /> ._ .___._......_........................................-.............__.__.- <br /> �s '�t 00C 111 TcaC.r <br /> I nsi <br /> -------.--............................ <br /> Is <br /> ynp <br /> P-----0 61 <br /> ,soda W+ 11k\'C <br /> IPWR fzOcS4 a tX6 mkeci- 0 o D (ups <br /> Wo r 9,w <br /> 0T\ <br /> D <br /> Vriv- in <br /> C <br /> y ci1rsfiW3eX ' rature„� suing`` ' <br /> ^T <br /> Name: LndWSInk: 'F Chlorine: ppmHeat: of <br /> Exp.Date: shing Sink: ; I �F Quat.Amm.: ppm Other: T <br /> Received By/Title: <br /> EH Specialist: Phone: Q &b 24/1�'/_ <br /> Time in: 'U Time Out: !t - t(] ~J �f Page;;a?f2— <br /> EHD 16-24 (2nd pg) 413/13 FOOD PROGRAM OR CONTINUATION <br />