Laserfiche WebLink
SAN JOAQUIN COI <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: <br /> L, I-1 Date: //7 p 5 <br />Address: 1 144,(4471-0 City: Zip Code: <br />Owner/Operator. "4) Telephone: <br />Program Element: ti lc Program Reeord: <br /> V`e 3 Inspection Type://e24...e <br />SB180 Posted Yes No Permit Posted es No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS , , <br />1-C <br />. . . 0 <br />(EWA ..W-C—ifilidA/Vek—W- <br />° *IN <br />. / / ./(V G(/‘ c (f/2 d / ,..... <br />r -.6q;PLO a0Vd- 1 1 f 1 i t / <br />,o szat <br />b <br />I <br />AO% <br />i4M4 r <br />/ i <br />,..* i 1 t I ' 4 -?1 r <br />Item/Location 'ITemperature <br />— <br />T ' Item I Location Temperature <br />, <br />c '4'4 i (1/4,N, v f — kl-- <br />-•`- — /..1---61 ___________ <br />A Food Safety Certification , F Facility Hot Water Temperature I Warewashing <br />Name: 4 ' <br />IA) <br />Hand Sink: F Chlorine: PPm Heat: . <br />Exp. Dat . Warewashing Sink: t / 9 °F Quat. Amm.: ppm Other: . <br />Received By / Title: <br />A Aillgirolf ir EH Specialist: illiim.- Phone: Bra" di <br />Time in: q i, ,) Time Out: Page of <br />END 16-24 (2ro pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION