Laserfiche WebLink
SAN JOAQUIN COUF <br /> X ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c.., _ :P• Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.segov.org/ehd <br /> qc;FORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: w -t n. I Date: 12� <br /> Address: lbZ S S City:S Zip Code: <br /> Owner/Operator: k 4h - S Telephone- <br /> Program Element: Program Record: �� Inspection Type: <br /> B180 Posted Yes No Permit Posted a No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> IC, <br /> LAT - <br /> vuL w TAM., a� <br /> Item/Location Temperature Item!Location _ Temperature <br /> ........ -..... — <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: 'F <br /> Exp.Date: arewashing Sink: of Ouat.Amm.: Ppm Other: of <br /> Received By/Title: <br /> EH Specialist: /r Phone: <br /> Time in: / Time Out: U Page of <br /> EHD 16-24 (2n°pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />