Laserfiche WebLink
SAN JOAQUIN COUNT <br /> :< <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • c ., iP• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sl4ov.orq/ehd <br /> 4CjFo.��a <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: oc-T b'r1 I � Date: 1-1/W <br /> Address: 2 b 4, C City: &'jt--V f1 Zip Code: r� <br /> Owner/Operator: t` M w OI/ C� Telephone: �& 7S_�> <br /> Program Element: f 1 Program Record: Or `�, 2 Inspection Type: ?_CA_ _fVQ,_ <br /> VB180 Posted Yes No Permit Poste Yes No Re-Inspection on or After: —� <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> One- of inCl c,_. in Tbc OkAA-3i Me,,ri's oiA <br /> is CA CAA- lba aRa-in vk -e_ V-V)( 0,1> cvdo as ?o S's 1HLQ_ . <br /> Item/Location Temperature Item i Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: A Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: _ (Oct) <br /> Time in: L Time Out: , 00 lPage of <br /> EHD 16-24 (2n1 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />