Laserfiche WebLink
SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />a• ;a Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sogov.org/ehd <br />'dUaH'A' <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />of Facility: <br />�77-6Name <br />� (¢_ <br />Date: <br />Address: <br />I City: <br />Zip Code: <br />Owner/Operator: <br />Gv 0. .� <br />Telephone: <br />Pro gram Element: <br />/' Progr mRecord: .� SL�Zy(/� <br />Inspection Type: <br />SI3180 Posted �, <br />No Permit Posted/-Y-e!,)No <br />Re -Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />D <br />u <br />0 <br />`yi v <br />EavLrLe/ <br />c.r <br />Item/Locatlo-amperature <br />Item / Locatl <br />Temperature <br />Name: <br />. ertificetion Facility Hot Water Temperate <br />Hand Sink: <br />of <br />Chlorine: PPM <br />Heat: <br />=F <br />Exp. Date: <br />arewashing Sink: <br />of <br />Ouat. Amm.: PPM <br />Other: <br />AF <br />ceived By / Title: <br />1 A 7�H <br />/ <br />Specialist: <br />r <br />_� <br />�Nf <br />Phone: <br />me in: ', <br />Time Out: ', Z Page of <br />�...... ��....o.0 nie rnAmui iAnnu <br />EHD 16-24 (2^ pg) 4013 <br />