Laserfiche WebLink
0 <br /> SAN JOAQUIN COU <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> pal <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> . cq.. .a�P Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.or- /ehd <br /> �hFOR G <br /> J <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT v <br /> Name of Facility: 1 `S�= L k r J � Date: "2 - <br /> Address: 2 City: c zip Code: S� <br /> Owner/Operator: III, •] Telephone: <br /> Program Element: `b3 Pr gram Record: '- 1 CA Inspection Type: <br /> B180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: t T <br /> l 1 . <br /> OBSERYA7IONS AND CORRECTIVE ACTIONS <br /> L) <br /> 1 5-E- A,3seg <br /> A-0 �s <br /> Item/Location pTem�perature Item 1 Location Temperature <br /> �N .- 12 S f=s �-� 2 r <br /> Foo6l Safety Ce •fication Facility Hot Water Temperature ;-Warewashing_ <br /> Name: Hand Sink: 'F Chlorine: ppm Heat: 'F <br /> Exp.Date: 1 _ 2 2 arewashin Sink: t Z °F Quat. Amm.: ppm Other: 'F <br /> Received By/Title: <br /> EH Specialist: _ Phone: 14b <br /> Time in: j' S\ Time Out: Page of <br /> EHD 16-24 (2"^pg) 4/3113 , FOOD PROGRAM OIR CONTINUATION <br />