Laserfiche WebLink
SAN JOAQUIN COUN'i <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: Date: 1 I /2_27 26 / 5 <br />Address: 07at16/rW*11141YrOng -Cer/L- reetiat'e <br />3 5:5 0 ‘,L) S071 City: <br />54-6( ithr)1 Ai% Zip Code: <br />Telephone: .244,.....s-69i.f. Owner/Operator: kf (r.e I z ce Iret---11- A 0 A de <br />Program Element: / 6 ..i <br /> <br />. ..,_, <br />Program Record: r 0 6-s 5-8 Inspection Type: <br />P-Ot4 firL9-- <br />SB180 Posted LI Yes 74.eermit Posted FT Yes [7! Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />4--Cij? 0 F: 1) Z--- C 14' _13 <br />SR 1 gg II 0-e-- pos-f4/ ,. Fe r-41( 4o-& otil a ll et* <br />eitit c ` A S re_P--(1. 01 r42 ft) haava r'Ll ble <br />Task- 5 12 ° 4- T-e riyt —is eq, re+a il fyi 054-- rV_6614- <br />t <br />-----r"---::-:)il Ls50L12___ 2-0(47 r-ervc'e i <br />Item/Location Temperature item / Location ----17—remiwatuA <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: .F Chlorine: ppm Heat <br />— Exp. Date: Warewashing Sink: . Quat. Amm.: PPm Other , <br />Received By / Title: i 7 <br />EH Specialist: <br />J2-y (.j 43 Phone: 'FL a - 0335 <br />Time in: <br />i 41-- 6 2- Time Out: <br />/ 0 Z <br />Page of <br />END 16-24 (2^, pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION