Laserfiche WebLink
'" .� SAN JOAQUIN COUI ' <br /> y 'X ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 09.• ;P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> �%FORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: "'�\_-_� Date: t/ � <br /> Address: Wi ��`VV�L City: Zip Code: <br /> Owner/Operator: T(�w� Telephone: <br /> Program Element: Pro m Record: ,9—� , �? C� S - Inspection Type: �'V� <br /> 8180 Posted ❑Yes ❑ Rermit Posted V ❑Yes ❑1 Re-Inspection on or After: <br /> la Ism <br /> Tg <br /> �` I .3 <br /> r V AM �/t V , t <br /> QA,, 0 <br /> Iteml777 <br /> L or! Temperature Item I Location Temperature <br /> Food Safety Cer�fication Facility Hot Water Temperature Warewashing. <br /> Name: Hand Sink: of Chlorine: ppm Heat: F <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm ther: of <br /> Received By/Title: C-114 CA I <br /> EH Specialist: �Y V Phone: I I <br /> Lite <br /> _ <br /> Time in: Time Out: Page*>of <br /> EHD 16-24 (211pg) 4,'3,/13 FOOD PROGRAM OR CONTINUATION <br />