Laserfiche WebLink
y4P4Hle.fq� SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 4�Idaa�;p Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.siaov.orD/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: } Date: f2/z/2!0 <br /> Address: City: as.LV A_�_ Zip Code: q'� <br /> Owner/Operator: k K��\ Telephone: 'I <br /> Program Element: b Program Record: IZd" Inspection Type: <br /> 8180 Posted Yes No Permit Posted a No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Vine 7Zy L <br /> 1 <br /> 't-5 tAvA W\^0G e <br /> ?` '4- Jm- <br /> Item/Location Temperature Item I Location - Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: and Sink: 'F hlorine: PPM eat: "F <br /> Exp.Date: arewashing Sink: "F r <br /> uat.Amm.: PPM Other: "F <br /> Received By I Ti <br /> EH Specialist: Phone: 1V <br /> Time In: Time Out: Page of <br /> END16-24 (2-pg) 0913 FOOD PROGRAM OIR CONTINUATION <br />