Laserfiche WebLink
SAN JOAQUIN COUN <br /> X ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.s*gov.org/ehd <br /> �iFORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: i t 1 - �-k ex i (OD -(-,C_,L I Date: ' *>16 vs <br /> Address: , t i rr-r0/1 G City. ( C� 1� Zip Code: 0 c7;_U L, <br /> Owner/Operator: wit w p-)n L '�JCA' Telephone: Ar —� rr�' <br /> Program Element: 1 � ' Program Record: "> Inspection Type: L�� � <br /> LO <br /> Posted ❑Yes e Permit Posted G Yes I Re-Inspection on or After: —� <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> %ca. �n <br /> da <br /> S U C vrr Q c <br /> 5 -kur d kow Car S are P0-1 -bio n <br /> . 0It uta i le - Q . Pe <br /> 0 mil 4- Dr_:e �S ufi np_e <br /> �50\ un c <br /> 0 u S f L Go �r�_ S C,Q re s;fi e cJl 1 n t \Q' }OcK Vk;?G <br /> 4- <br /> Item/Location Temperature Item t Location Temperature <br /> m.... W ., ..... _..._..- _W <br /> d V I Gl& 1 G0> �,��- v_\ -�t>ti4 <br /> a CkF_ �3a\ Q(�(c ur_dcLrlr �5� P CA-ar _ I� e Vh wtkk <br /> ... - _ Y <br /> v�cln-hc C_ nc,A- afire c <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: l U L °F Chlorine: ppm Heat: �F <br /> Exp.Date: Warewashing Sink: 1�(J of Quat. Amm.: ppm (Other: F <br /> Received By/Title: <br /> EH Specialist: `- - Phone: <br /> Time in: \� _1:1-U I fjTime Out: ' "I ") Pagef of <br /> EHD 16-24 (2^'pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />