Laserfiche WebLink
Pqu�" SAN JOAQUIN COUN <br /> � •.pG <br /> z z ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.si4ov.org/ehd <br /> �/FORS <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ! W el t+11 14 Date: <br /> Address: 3 C© City: Zip Code: % 52 <br /> Owner/Operator: 9"q- Telephone: 7q_ � <br /> Program Element: 16,ani Program Record: io k . Z D2 Inspection Type: <br /> SB180 Posted tXYes F No Permit Posted XYes ❑No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> C44s .,CLq ci C=! <br /> d 2n© <br /> rP <br /> IC4- <br /> Item/Location Temperature Item/Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: 'F <br /> Exp.Date: Warewashing Sink: aF Quat.Amm.: ppm Other: 'F <br /> Received By/Title: ' <br /> EH Specialist: Phon <br /> g53- ?8 / <br /> Time in: ; �5 Time Out: S 5 Page I of <br /> EHD 16-24 (2°"pg) 11/2/09 FOOD PROGRAM OIR CONTINUATION <br />