Laserfiche WebLink
N. <br /> SAN JOAQUIN COUN <br /> 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 /> ��FORt� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: U !!! i ��r� Date: I <br /> Address: Qy11_ 1' IV City: Zip Code: <br /> Owner/Operator: SIJ l Ov f'C If1 ✓!%x ' Telephone: //„_'7� 7� <br /> Program Element: a Program Record: Sl,0/tom 7��� Inspection TypetF� ,., C� <br /> B180 Posted ❑Yes ❑ Rermit Posted /���'❑Yes ❑1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> - <br /> �( <br /> Item/Location Temperature Item/Location Temperature <br /> Food Safety'-Ce- ficatio Facility Hot Water Temperature Warewashing <br /> Name: /�, Hand Sink: 1 ) of Chlorine: ppm Heat: of <br /> ALX /J' _ ___---- <br /> Exp. Date: Warewashing Sink: of Quat.Amm.: ppm they: of <br /> Received By/Title <br /> EH Specialist: Phone: <br /> Time in: . 1 Time Out: Page of <br /> EHD 16-24 (21"pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />