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SAN JOAOUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 EAST MAIN STREET, STOCKTON, CA 95202-3029 <br /> iii nt7 TELEPHONE:(209)468-3420 FAX:(209)464-0138 WEB:WWW.SJGOV.ORG/EHD <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes E: No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Item/Location Temperature Item/Location Temperature Item/Location Temperature <br /> Food Safetv Certification Facility Hot Water Temperature I Warewashino <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: Time Out: Page of <br /> EHD 16-23 (god pg) 8/14/08 FOOD OR CONTINUATION <br />