Laserfiche WebLink
P°"!" SAN JOAQUIN COUN _ <br /> � •.OG <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> = 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:vmw.sigov.org/ehd <br /> �IFORi' <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 0­1dDate:l <br /> Address: 2 �! /� City: Zip Code: <br /> Owner/Operator:! a ,,,�/1 t '�,�/ �� Telephone: <br /> Program Element: ?:;2 Y� '�Pr+ogram Record: > 7 <br /> Inspection Type: <br /> B180 Posted Yes ❑ Permit Posted IF <br /> es ❑1 Re-Inspection on or After: <br /> momI <br /> ate:. <br /> t 3 &Vm a vL <br /> ,,k- K P AAA Sad r►�t <br /> L�- " <br /> d llId.W c�,b ytX Lit vLe <br /> Item/Location I Tempers r tore <br /> Certification Facility Hot Water Temperature Warewashing <br /> Name: h✓ Hand Sink: - 'F Chlorine: ppm Heat: °F <br /> Exp.Date: I arewashing Sink: 2 of uat.Amm.`0-I SO ppm Other: 'F <br /> Received By/Title: <br /> EH Specialist: IN13Phone: ll� —G3 _s 7 <br /> ime in: l i},, Time Out: T [Q / Page�of Z <br /> EHD 16-24 (2n1 pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />