Laserfiche WebLink
QAa"•" SAN JOAQUIN COU ! <br /> lLtd'Fq ` <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> adz/Fdd� P Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: LO A {f CA # Date: „ / , J.I7 <br /> Address: ) —1 I } 5 • V I 1 G�n City: 5 Zip Code: 9546, <br /> �yy 924- 1 (41Y <br /> Owner/Operator: L ( ; I i N / r C. :nC Z ((,I '4eeen Telephone: <br /> Program Element: b 3 Program Record: S R a 'C; <br /> InspectionType: ` <br /> 8180 Posted Yes No Permit Posted Yes No Re-inspection on or Aker: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 1/:uIu4;un,5Ccrerefel ! a• <br /> j F1 Pr V., d a IJgJr� in I J a C X' <br /> „n ; A + 2 <br /> 0• K jo MpliA ; j1 Q/1 (C -r"ej ha 6'e b"en <br /> Item/Location __ Temperature Item/Location Temperature <br /> ra I F <br /> Food Safety Certification Facility Hot Water Temperature _ Warewashing _ <br /> Name: Hand Sink: of hlorine: PPM Heat: of <br /> Exp.Date: arewashing Sink: of uat.Amm.: PPm ther: of <br /> Received By/Title: .. <br /> EH Specialist: Phone: I//<"i/U/J, <br /> Time in: Time Out:4'G Page of <br /> C 8:J2 <br /> EHD 1624 (24 pg)4/3F13 FOOD PROGRAM 018 CONTINUATION <br />