Laserfiche WebLink
• °"`" SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • .. ;P• Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> �L�FORN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: L h - ,l U R." W Date: f`} 14 <br /> Address: - G(' S , ci •b F � City: slb(J1C-J- 1 Zip Code: CA�ZIS <br /> Owner/Operator: �JJ Telephone: q,¢t- 2 <br /> ��a �nv r25��fiS 1,L, <br /> Program Element: 'b( Program Record: 0rqU--7, bj-c-., Inspection Type: pmt-- <br /> SB180 Posted VYes ❑ No Permit Posted KYes ❑ No Re-Inspection on or After: T� Weer <br /> L,2PSERVA i ION$AICD CORRECTIVE ACi1QtvS <br /> �ic+ a n mun Sxe V ne0l-1 <br /> vsbaves'l-e%'tt. n C:IS o CJI DSS I bLa <br /> Gle at f 0n <br /> u vva s fin . n 3 <br /> fig <br /> .same t �bui 1 u vel �� Qe o YQ, <br /> a0)-Tjs Cod ck . <br /> r4VI W S ,n C. t7e on s-+e_ <br /> &or1 W 9-0(j rE, GQ-WT <br /> SP w� i-o I� �NUIK i n 4 t�_ <br /> Woo- AM- icor o ((,U(edl T <br /> dr <br /> Name: 1,V!' jC11/ 1 Hand Sink: i U� aF Chlorine: ppm Heat: aF <br /> Exp.Date: 1,Sl/1 l� arewashing Sink: 2(j eF Quat.Amm.: ppm Other: of <br /> Received By i Title: <br /> EH Specialist: Phone: <br /> Time in: (j Z� Time Out: ;v. I) U V PageZof2 <br /> EHD 16-24(2n°pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />