Laserfiche WebLink
SAN JOAQUIN COUP t <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • cq.. iP• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s'gov.org/ehd <br /> ��FORt•N <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: i Date: <br /> Address: r r-1,4 <br /> u City: CKjo n Zip Code: (2, �o3 <br /> Owner/Operator: ViA ra r0 n q Telephon 6I�6� 7 10 46,21 <br /> Program Element: It 03 Program Record: R O D 7 703 Inspection Type: ��V <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> f OB§ A NS.A. C , RECTIVE ACTIONS <br /> . <br /> G �JIU- 8 <br /> ' h CP� a5 ��30 �50 - <br /> 1 es n 2 6am o� O�cJhP r, er <br /> Gov /e O� o e -740 0 O c� c r r!a 5 <br /> i k vhA n ..Tanc-f lllaV vro ) cov tC o� <br /> r fc <br /> rw tt a ►-'b�t o,- <br /> M r G X ct L e- - Gh d - 4D•A., <br /> /.c)at-kC r %S ct f- l 0 O • L/.L b c)c <br /> ,e D G�c rd Urr'ctC r ra r <br /> Wa r .17 <br /> rt ro <br /> (Pats' tow -�/Ow ►� Cold w r . r Cu �+� L 4, <br /> n GL T e C--S �u G �'r1 <br /> o "Cat. ry ra r" I kv3 'oZ <br /> Item/t-oca OREMmml ' <br /> warevlras r <br /> Name: Hand Sink: Ila of Chlorine: b ��O ppm Heat: of <br /> Exp.Date: Warewashing Sink: /O of Quat.Amm.: ppm Other: 'F <br /> Received By/Title: <br /> EH Specialist: Phone: GG✓6 <br /> Time in: Time Out: / .D Page of <br /> 7.3 <br /> EHD 16-24 (2nd P9) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />