Laserfiche WebLink
SAN JOAQUIN COW - <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.orq/ehd <br /> <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: ill ( /14 v 4" Date: i / c <br />1 City: Address: / s- Li Iv , <br />s <br />t_ c havvi. Zip Code: <br />Owner/Operator: Am r-vyi IV),/,,Itratei V Telephone: (.9 0C1 cd.ig-E- <br />Program Element: 1 it 2..,77 Program Record: 0 5 97 Li I 1 Inspection Type:A.,014.44/_4 <br />SB180 Posted 0 Yes 0 Rermit Posted 0 Yes XI Re-Inspection on or After: tA/ttek... 44 <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />1 i C q ki 41a- SOg <br />0.) 14.d.4-- orr,(A)ZA ok) <br />1 a-o r ,okr- <br />v v otAvt" kur-gx., 041 -0,--kkv-vo.kAzr,k-A-A 0}- _AA 1 1- c-- - PvtA,VaL__ <br />Wait vv` WM-I"- OU- Vb C <br />0 f <br />, II , . -i--- % ./ i ! )-- .)---0 1 E- q 0 t i, • <br />Item/Location _ Tempera e _ <br /> <br />Item / °cation <br />— c_.e. 'v -1.- 4 <br />Temperature <br />74)- i- <br />-,,,,,, <br />Certifica On <br />Name: <br />Facility Hot Water Temperature <br />Hand Sink: 0 <br />ashi <br />Heat: O F Chlorine: ppm <br />Exp. Date: Warewashing Sink: 0 Quat. Amm.: ppm Other: . <br />Received By / Title: 4, <br />EH Specialist: <br />1 _____-(10144—) <br />Phone: 514,514,e _ig,$) z"\ -----v v /a Time in: Time Out: Page )of <br />EHD 16-24 (2. pg) 4/113 FOOD PROGRAM OIR CONTINUATION