Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> 14: ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.s'gov.org/ehd <br /> ��FOFt� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: d. /; , Date: S ` <br /> Address: '?J� 4 a City: Zip Code: <br /> Owner/Operator: 04 V-a_, Telephone: <br /> Program Element: 1X ) Program Record: 0 I ��6' (� Inspection Type: vu <br /> 6180 Posted ❑Yes ❑ Rermit Posted ❑Yes ❑I Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> VV f ; <br /> ✓�, /�� �� � 1, r�.1 <br /> P� vIJ� zo - <br /> Temperature <br /> 1�,( -t <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> _.__ _ —_ _ <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: of Quat.Amm.: ppm ther: of <br /> Received By/Titl . <br /> C <br /> EH Specialist: vw Phone: <br /> Time in: Time Out: / Page 4of <br /> EHD 16-24 (2""pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />