Laserfiche WebLink
oea I". SAN JOAQUIN COUNTY <br /> ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • Cq t'FOQ��o'• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siaov.oro/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 No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> emperature <br /> Food Safety Certification Facility Hot Water Temperature ' _rewrh'nqr <br /> Name: Hand Sink: of Chlorine: ppm of <br /> Exp.Date: Warewashing Sink: .F Quat.Amm.: ppm of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Tim in: Time Out: Page of <br /> EHD 16-24 (20°pg) 41113 FOOD PROGRAM OR CONTINUATION <br />