Laserfiche WebLink
SAN JOAQUIN COUN <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sidov.org/ehd <br /> �iFoaa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: �t�` .11� 1 Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted ❑Yes ❑ Rermit Posted F.Yes ❑ I Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> I 069CA-q est 3 1 ebN4 rouches. ReAAcNZ and <br /> Crm�'ir1u.� Q tc311�) <br /> i S J10w w CX)d \,M e in ire- , Vain-v- Qi1 <br /> h �� wd with S•P.mi \oSS C.2 fih.� w Ui;X.1 heed S <br /> -rz> e 1 Cid l 0 vY i Jt t� -fit' w _1rq <br /> LCj 0 roo it i <br /> Item/LocationTemperature � Item!Location Temperatur <br /> _........_ <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink. aF Chlorine: ppm Heat: of <br /> Exp. Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title, <br /> EH Specialist: Phone: <br /> - <br /> 9W- 4i _ <br /> Time in: �1 U Time Out: r =2� Page/of <br /> EHD 16-24 (2n1 pg) 413113 4 FOOD PROGRAM OIR CONTINUATION <br />