Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> a ENVIRONMENTAL HEALTH DEPARTMENT <br /> H: :< <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • cq., �;'a`P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sjgov.org/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: t "Ir Date: ( 70 <br /> Address: / • G*_ City: Zip Code: 067,10-1- <br /> Owner/Operator A <br /> 67,10ZOwner/Operator: M k V Telephone: <br /> Program Element: `�UQ Program Record:co 5 � Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> c O,BSERVATIONS AND CORRECTIVE ACTIONS 1 <br /> a aO I' 1 M' �' 4Inn ' ( a <br /> 'M -t NV11"r <br /> W 'Bh d <br /> _ N Ovt <br /> c� <br /> x �S <br /> • ✓�j V G 'rv�t oe4 lhls. Wt <br /> Item/Location Temperature Item 1 Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: /) Y1 <br /> o V <br /> Time in: r� Time Out: Page of <br /> 16 <br /> EHD 16-24 (2111 pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />