Laserfiche WebLink
• � ou'M <br /> ,P coa SAN JOAQUIN COL 1'Y <br /> �k ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ = 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.segov.org/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: h I ,�' C-'_ Date: �.— <br /> ddress: 3� City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: \ Program Record: Inspection Type: <br /> �SBI_80 Posted ❑Yes ❑ Rermit Posted ❑Yes ❑1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Z-c'v_1C <br /> p <br /> Itemtl_ocaGonTem erature -, Item F L <br /> p <br /> u Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm (Heat: of <br /> 1 <br /> Exp.Date: arewashing Sink: of Quat.Amm.: ppm (Other: of <br /> Received By/Title: <br /> EH Specialist- P Phone: <br /> Time in: �I l �i Time Out: 'C Page i of <br /> EHD 16-24 (2n°pg) 4/3/131 1 J FOOD PROGRAM OIR CONTINUATION <br /> �b� ' <br />