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F0 PROGRAM OFFICIAL INSPECTION REST <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DMSION (209) 468-3420 <br />304 E. WEBER AVE., P.O. BOX 388, STOCKTON, CA 95201-0388 <br />I <br />pnam auE <br />TEL l l <br />DATE <br />I <br />AnnRF.S,s �A <br />PRI a <br />i <br /><7+WFRrOpERATOfTEL <br />( ) <br />TME W <br />TME OUT <br />►eAILN,G <br />RMIT 0 ICE <br />Pj <br />TRAKSFER DATE <br />1 <br />FOOD ACIUTIES OPF_RATmKi wrAAOUT A VALID PERMIT ARE SUBJECT TO CLOSURE. TRANSFERS OF OWW-RSHP NOT REPORTED WITHIN THIRTY (301 DAYS FROM THE 1 <br />RECORDED DATE OF TRANSACTION ARF SUR KiCT TO THE BASE_ PEAUIT FEE PLUS 100% PENALTY. <br />0! bvinI; Quarters 1721 174 <br />i j Signs -Permits 1751 176 <br />ESTAB. STATUS' (MARK ONE) <br />{ %? 78 79 8C 81 <br />1EE1 GAFi r-- <br />� PI 'I' <br />LEGAL ACTION <br />3 83 F4 <br />_ r— <br />IGTATrON; ;CLOSURt1 I OTHFP <br />EH 01 02 skis 134 (9/95) <br />REINSPECTION DATE <br />ENVIRONW14TAL HEALTH PERMIT AND SERVICE CHARGE FEES ARE � RECEIVED BY. <br />AUTHORIZED BY SAN JOAQUIN COUNT`/ ORDINANCE. ALL DOCUMENTED ('w, <br />IMMEDIATE HEALTH VIOLATIONS OR REPEAT VIOLATIONS ARE SUBJECT IRONMF L HEALTH SPECIALIST <br />TO A REINSPECTION AND REINSPECTION FEE ALL UNPAID CHARGES <br />ASSOCIATED WrrH.THE FACILITY OWNER OF RECORD OR APPLICANT <br />SHALL BE PAID PRIOR TO THE ISSUANCE OF A PERMIT TO OPERATE. I AGE OF <br />THE FCX.I.OMIauG ITEMS REPRESENT HEALTH CODE VKXAT1DNS AND MUST BE GOHH1=u TtD IN AC.�[.AL Lkw .;t <br />WITH THE IDENTIFIED TWE SCHEDICES: <br />I MAJOR ( MANOR <br />fooc Temo. <br />1 1 2 <br />J(e <br />_ <br />J 1 <br />Zj <br />Prep+Service <br />1 ! C <br />1 <br />Storagef l)=. <br />1 51 <br />6 <br />I <br />c� <br />Frozen Food <br />Uf <br />v <br />l <br />C I <br />7 <br />1 8 <br />w <br />b <br />0 <br />Pure Fooc <br />9 � <br />/— <br />1 <br />, <br />11 s <br />a <br />Reuses F000 <br />, <br />131 1141 <br />1' <br />Transoonatl-,4-p <br />G <br />Harwwasninp <br />� <br />Disease Trans. <br />117 118 <br />G <br />Employee Habits <br />119 1201 <br />1 L2fn <br />a Ii <br />Z <br />Rocients <br />21 12201 <br />1 <br />¢ <br />Insects <br />1 <br />23 24 <br />25 26 <br />> <br />Animal/Fowl <br />wasA.isant. <br />27 128 <br />_ <br />Z a <br />Eauio. Conn. <br />1291; 130 <br />►w- O <br />Wen, Cond. <br />31 132 <br />M w <br />Storage <br />331 134 <br />' ' <br />' " <br />storage Fac. <br />1151 136H <br />uj <br />Q <br />Refng. Units <br />371381 <br />1✓` <br />391 1401 <br />0 cc <br />Th rmcxneter <br />41 142 <br />u. <br />tvzarams Mat. <br />S"Is <br />43 Ida <br />F <br />water451 <br />146 <br />j <br />j <br />3 <br />Cross Conn. <br />jA71 148 } <br />f <br />L <br />LIDUId waste 149 <br />150 <br />! <br />r - <br />Q <br />Ratuse <br />15 (52 <br />3: <br />Premises 1531 15A <br />1— 21 <br />Larst orles <br />55 1561 <br />57 58 <br />I <br />U) O O <br />Toilets <br />59. <br />a:60 <br />Dressing Roams <br />t <br />Ventilation 1613 162 <br />L" <br />Floors 1631 <br />164 <br />I <br />wens-Cewric 65 }651 <br />Q <br />Janitorial Fa--, 1671 <br />168 1 <br />1 <br />I <br />I u- <br />Lighting 1691 170 <br />I <br />Goynng-Linen 1711 172 <br />0! bvinI; Quarters 1721 174 <br />i j Signs -Permits 1751 176 <br />ESTAB. STATUS' (MARK ONE) <br />{ %? 78 79 8C 81 <br />1EE1 GAFi r-- <br />� PI 'I' <br />LEGAL ACTION <br />3 83 F4 <br />_ r— <br />IGTATrON; ;CLOSURt1 I OTHFP <br />EH 01 02 skis 134 (9/95) <br />REINSPECTION DATE <br />ENVIRONW14TAL HEALTH PERMIT AND SERVICE CHARGE FEES ARE � RECEIVED BY. <br />AUTHORIZED BY SAN JOAQUIN COUNT`/ ORDINANCE. ALL DOCUMENTED ('w, <br />IMMEDIATE HEALTH VIOLATIONS OR REPEAT VIOLATIONS ARE SUBJECT IRONMF L HEALTH SPECIALIST <br />TO A REINSPECTION AND REINSPECTION FEE ALL UNPAID CHARGES <br />ASSOCIATED WrrH.THE FACILITY OWNER OF RECORD OR APPLICANT <br />SHALL BE PAID PRIOR TO THE ISSUANCE OF A PERMIT TO OPERATE. I AGE OF <br />