Laserfiche WebLink
SAN JOAQUIN COUN . . <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.sigov.orq/ehd <br />4<<FORa <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: , <br />c (I S h 5 S <br />Date: <br />/- , 3 j- l q <br />Address: a q6 <br />W.+ L, n City: <br />is <br />T/c,C <br />Zip Code: <br />9S30Y <br />Owner/Operator: <br />fTelephone: <br />3v -C,5 S <br />Program Element: <br />Program Record: <br />Inspection Type: <br />SB180 Posted Yes No <br />Permit Posted Yes No <br />Re -Inspection on or After: <br />=. <br />OBSERVAT)flNS AND,CORRECTIVE ACTIONS <br />u6W <br />G -L7-- <br />�+—�i i �• 9 S �1 C t, J� s' M <br />G ✓r G <br />A 1/ <br />Item/Location <br />l <br />Temperature <br />-`Item / Location <br />Temperature <br />lufbo -Ci r <br />.' <br />- <br />i <br />Food Safety Certification <br />Facility Hot Water Temperature <br />Warewashing <br />Name: I <br />Ha d Sink: jS <br />F <br />Chlorine: <br />ppm <br />Heat: <br />'F <br />Exp. Date:L=Ing <br />Sink: , <br />of <br />Quat. Amm.: <br />ppm <br />Other: of <br />Received By / Title: <br />\,- <br />EH Specialist: <br />Phone: <br />Time in: � <br />Time Out:/ems <br />! <br />Page sof <br />EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />