Laserfiche WebLink
'�q4 apo SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • Cq., - a(P -Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.s6gov.org/ehd <br /> ��FOR <br /> P(2. 0 'Sii1, (ol y bra 001 " Oo$ <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> ame of Facility: Q t ; n Date: � _ Z <br /> 8 <br /> ddress: 112 5 1 G r City:—, '. Zip Code: Q. 7S 3 <br /> wner/Operator: W J Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> 8180 Posted ❑Yes ❑ Rermit Posted []Yes ❑ I Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> T <br /> Q r W � \ham( <br /> S k 0 - ba-I <br /> \ Ser 0z Us-ziF- <br /> - 2 <br /> C A AQ b2(o <br /> r\ 2C) C l� <br /> chap _ <br /> i <br /> Food SafetyCertification Y WarewfingFacilitY Hot Temperature _ '` <br /> Name: (Hand Smk: eF Chlorine: ppm Heat: °F <br /> Exp.Date: =rewashing Sink: _ -F IQuat. Amm.: Ppm Other: of <br /> eceived By/Title: <br /> EH Specialist: Y� Phone: ry bl 1_ _ 7�',r�,-�� <br /> Time in: 1-Z: �� Time Out: 12 ' �J Pagelof I <br /> EHD 16-24 (200 pg) 4/3!13 OOD PROGRAM OR CONTINUATION <br />