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SAN JOAQUIN C0UNN./ <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.s ov.org/ehd <br /> {FFpR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Date: <br /> Fddress: <br /> cility: <br /> City: ' Zip Code: <br /> Uf , 12U Telephone: <br /> rator: Yc C�Pro ram Record: Inspection Type:lement: ia1 f� g <br /> 6180 Posted V❑+Y✓es 0 Hermit Posted ❑ es ❑ Re-Inspection on or After: <br /> � 3 0 STN. <br /> �. C <br /> �- <br /> ~ V <br /> , <br /> tom' <br /> Temperature <br /> Pond f; CBrEifatF4 ,. i hit atsr Teem" rare. 1Nare+zast in <br /> Name: Hand Sink: -F Chlorine: ppm Heat: "F <br /> Exp.Date: arewashing Sink: 'F Quat.Amm.: ppm Other: of <br /> Received By!Title: <br /> EH Specialist: Phone: <br /> Time in: 167 <br /> Time Out: 10 to o Page of <br /> EHO 16-24 (2w pg) 4013 F00D PROGRAM 01R CONTINUATION <br />