Laserfiche WebLink
SAN JOAQUIN COU <br /> Q` ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �q.... a;P.. 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: ' La l 6)co -SI Date: IU�I� <br /> Address: /Z� r 6() S City: C) Zip Code: G F)7 Uv <br /> Owner/Operator: VI - M Telephone: ( , 4730 v <br /> Program Element:—\ 1�Z Program Record: P� t (,q !� Inspection Type: { (� <br /> SB180 Posted Yes 1 No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> w x1 <br /> - 771 <br /> cCrA sin uin v ui� r c <br /> Ckn U1 (-Aa P <br /> VU I <br /> 'COk Un GkL1` <br /> T CX - (SCGf h r f960c- .m-e.- <br /> �ln�fi w U r- Rni I i <br /> I-e �f �'nifl e Ccrf� cA1 SI <br /> �S r-1 <br /> ce d i n . 'J�(/�I r�-Et.�i a �F l c �n Gl F rn . <br /> ftgn,4af cafzkS CAT-P L_n Si-W- ICU i n 2w e2KS <br /> l'D u -ft OV- QGk V�lh Pmt�i�k hv} L`1Z n 2 <br /> Item/Location Temperature Item!Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: F Chlorine: PPM Heat: 'F <br /> Exp. Date: Warewashing Sink: of Quat. Amm.: ppm] <br /> pm Other: 'F <br /> Received By/Title: <br /> EH Specialist: Phone: r,({ <br /> ime in: Time Out: lJ� Page of ' <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />