Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
SAN JOAQUIN COU Y <br /> y. ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> •oq., arc Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sm ov.orq/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: LCA CM M"70U o 0-\ _y i- c , N Date: `G E 16 (6 <br /> Address: a UU t- ft <br /> ) City: 5t04—tU t� 1 K <br /> Zip Code: l <br /> Owner/Operator: L P rn�.1� �— � Telephone: �^W4-131-� <br /> Program Element: \ ro�U Program Record: p(7 U� Inspection Type: r1,- nT <br /> SB180 Posted es No Permit Posted 1 No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> fo3Se �1 ck& -jjwi u cl cveA4 _WXA CCjnW1I`h4t.4_ <br /> CAo&'(3j wwe-N h Nn <br /> 2 <br /> K" <& S IS Ckrd S �Yi' 'e - <br /> P'itGt CA4 �n ` we <br /> wG1W pt- Trte OwtS\cLc 3CcsM Sine <br /> S <br /> at b f• W6 _Vo 12U F <br /> tt t-,ev__lt_4�-_fes_ Cil +� <br /> Item/Location Temperature I Item f Location ! Temperature <br /> Food Safety Certification ` Facility Hot Water Temperature Warewashing <br /> _ <br /> Name: Hand Sink: U of Chlorine: ppm Heat: F <br /> .-_........_... <br /> Exp.Date: IWarewashing Sink: of Quat.Amm.: ppm ther: 'F <br /> Received By/Title <br /> EH Specialist: Phone: <br /> 'zcl�1 — -344 to <br /> Time in: U: ofTime Out: i' �U Page f <br /> EHD 16.24 (2n°pg) 413/13 l FOOD PROGRAM OR CONTINUATION <br />