Laserfiche WebLink
SAN JOAQUIN COU <br /> ya ENVIRONMENTAL HEALTH DEPARTMENT <br /> a: X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • ..: ;P, Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sogov.org/ehd <br /> 4�/FORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: r Date: _�2 _f <br /> Address: City: i C� Zip Code: ,5 .zi:3 <br /> Owner/Operator: Vellyr . I r Telephone: Ljj��_3 (I 2 <br /> Program Element IT <br /> Program/Record: �� �_39'3 Inspection Type: n i J <br /> SB180 Posted ❑Yes ❑ Rermit Posted D Yes ❑ 1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> \J, L0tb n <br /> 'o✓'K- fpl t kA w n <br /> t Y%e. yjas ro v-; 4b da <br /> r o 4- at o c,-Z Ut-6 U no vi b <br /> y -f (.� l,e�l e l -� m <br /> cow, - <br /> -fu-c. 1 q- cv tr-�x.i-n oo rn <br /> r �oQrChiar d r <br /> W- <br /> + , 5 o� <br /> Item/Location Temperature Item!Loca.... , Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink -F Chlorine: pprn Heat: "F <br /> Exp. Date: arewashing Sink: of Quat.Am <br /> m.: ppm 'Other: °F <br /> Received By/Title: <br /> EH Specialist: V _ p Phone: <br /> Time in: / 0 Time Out: 10 Pagj of j 100 <br /> EHD 16-24 (2n'pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />