Laserfiche WebLink
SAN JOAQUIN COLO <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siciov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: -/..1.-2 i-C) L 6)21Z— t,'Y't--.-4 ( <br />Date: <br />Address: 3s-ro /kiwi isen uhufr <br /> <br />City: <br />Silt, elbl'T/i • <br />Zip Code: 4;) c 2 0 c _ <br />Owner/Operator: f <br />") Telephont2 x05-10,'106 ,, <br />Program Element: Program Record: /7 a, ,$ - Inspection Type: <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: geti,75 tkt . <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />A0-4/— <br />...C'i ---Xa -.,4e740( Pr-co i'4'- g;e_e., 4 ,. <br />11 <br />lat kliff)J /01/1,••<_ 3 <br />tar, t# / j-4,/ -7<, <br />ca A .74:7 i SS t.i.c {2i'/ 9' ‘).cle / <br />ptece V <br />Item/Location Temperature Item / Location Temperature <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: .F Chlorine:PPm Heat: , <br />Exp. Date: Warewashing Sink: °F Quat. Amm.:PPm Other: o <br />Received By / Title: <br />EH Specialist: Phone: <br />q c /g -3 -71f- <br />Time in: Time Out: Page of <br />II/3D 1411 I / ,' Y c7-4-1-1 <br />EHD 16-24 (2^d pg) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION