Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
SAN JOAQUIN COUv4TY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ... �P• Telephone:(209) 468-3420 Fax.(209)464-0138 Web:www.sigov.org/ehd <br /> 4CjF�Rt� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 0 Date: ' Z Zv <br /> Address: City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: 0 Inspection Type: <br /> SB180 Posted Yes Pot—Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> "�l ► � S D r <br /> r� Irw <br /> I L +i <br /> 3 4=( C <br /> ✓ 20 <br /> 1 <br /> 2 _176, 1Viol <br /> 90 o <br /> LCI <br /> ce 44 a 162 <br /> Abr 89000 <br /> r <br /> f <br /> 1 � <br /> --C_ A& <br /> . U <br /> �- <br /> L V �� r s�zIC. A/s "' c-c� ;A V,�Ic �' r �n' -� � .� <br /> Item/Location Temperature Item/Locatiod 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: rT" Phone; �6 O <br /> ime in: <br /> -J Time Out: Page of <br /> EFOOD PROGRAM OIR CONTINUATION <br /> HD 16-24 (2M pg) 4/3/13 <br />