Laserfiche WebLink
SAN JOAQUIN COU1� <br /> Z-+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: x <br /> _ = 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �'.. iP Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> gr;Fo¢a <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: k-- Date: �- <br /> Address: !M,� /� City: 1 ' Zip Code: <br /> Owner/Operator: 1/1.. L y1,' k� v�f Telephone: <br /> Program Element: V �U),2 Program Record: Inspection Type <br /> j 0z)11 <br /> B180 Posted u ❑Yes ❑ Permit Posted ❑Yes ❑1 Re-Inspection on or After: <br /> • <br /> r <br /> tX/l IN1 Ii1i ?� <br /> of)/?ic <br /> a c - <br /> Item/Location <br /> N fiacrl►t Not,llVatgr Temperature wastar�gr <br /> Ware � <br /> Name: Hand Sink: of Chlorine: ppm Heat: aF <br /> Exp.Date: Warewashing Sink: of uat.Amm.: ppm Other: of <br /> Received By/Title: L <br /> EH Specialist: Phone: <br /> Time in: Time Out: 2 , 0 Page• of <br /> EHD 16-24 (211 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />