Laserfiche WebLink
SAN JOAQUIN COLIN <br /> Q` �+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> <<FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 1, 1 r 4 0 V.22)O Date: �G r�S <br /> Address: _P)O s - ��1 fl_` a City: S .�- Zip Code: `-'I�i52O� <br /> Owner/Operator: ✓1�5 rl Telephone: 1 6 15 <br /> Program Element: (0 I"Plrlogra'Imt Record: ?l� 5C) C, :' Inspection Type: <br /> B180 Posted Yes ❑ Permit Posted Yes ❑ I Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> o on <br /> 3r)`110 u+ 'R11 I n <br /> S RA-1CAA -ILQ- - CCA-T -4e. <br /> Cam �rnr,2 � <br /> o til fioSLOCAC LGt S , cel r <br /> V f c Ca ,�u fi , b 1 can tov-e. Le <br /> 1 ( mg i n ivo-IC&r. <br /> �GtGi I hOLS v . C N R" - fi Qi A-V-1,tCX- - <br /> ba� \ s -0 - Cvrc4ec1A_CGl o_�N FI.-Ii W_ <br /> € ...,...� uy,,itemtLocation Temperature Item Location Temperature <br /> Facility Hot Water Temperature Warewashing <br /> .. _ .....,._.._ <br /> Name: Hand Sink: of (Chlorine: ppm !Heat: of <br /> Exp.Date: `� arewashing Sink: ' oF ppm i Quat. Amm.: Other: oF <br /> Received By/Title:/ <br /> EH Specialist: Phone: <br /> time in: I Time Out: Page, of <br /> EHD 16-24 (20°pg) 413/13 FOOD PROGRAM OIR CONTINUATION <br />