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SAN JOAQUIN COL .•Y <br /> X <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.slgov.org/ehd <br /> L�FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: LAQ (' tex La v­e, Date: _ 2 y <br /> Address: 2 City: Zip Code: Iq 5? (40 <br /> Owner/Operator: K ic is 4i n2 10 r r Telephone: 0-7 <br /> Program Element: 1 <br /> O I 2 15 f�^rogram Record: O —j I Inspection Type: f na I <br /> SB180 Posted i Yes i No. Permit Posted -Yes I No Re-Inspection on or After: / <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Ck__(. ✓4_' c <br /> l ` <br /> Y� r <br /> DfRt ,11 <br /> ,r'8� I - I <br /> Z h-e r <br /> l.0 <br /> IJ <br /> ' i bu kv-- <br /> ssa r r <br /> ALC qlape rt U_% ctrooti8 q n-moi.-r r c ha' <br /> w <br /> LF00 8 i'YLa ho e r r r r O coot <br /> O K -}n 66SUe_ ver rr 4 - rzrirn m e -orel 'bpt-e 01W 15 <br /> • N e 3-core or4 h c r si'.-K <br /> I 'To rA LU Lis c't <br /> item/Loca ion Temperature 6 IIItem/Location Temperature Item/Location Temperature <br /> '3 <br /> R <br /> Food Safety Certification Facility Hot water Temperature Warewashmg <br /> Name: Hand Sink: of Chlorine: PPM Heat: of <br /> Exp.Date: areW�shjn?Sin : of Ouat.Amm.: PPM Other: of <br /> Received By/Title: f i 'YY <br /> EH Specialist: Phone: <br /> Time in: O Time Out: Page of <br /> EHD 16-24 (2nd pg) 4/9/12 FOOD PROGRAM OIR CONTINUATION <br />