Laserfiche WebLink
oPRk'n..e SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />cgri a'a� p Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siaov.ora/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />N <br />Date: Z <br />ddress: <br />City: <br />Zip Code: <br />wner/Operator: <br />rt <br />v <br />Telephone: <br />Program Element: / <br />V( H <br />Program Record_ O S 8 <br />Inspection Type: K ?.y_' <br />8180 Posted es <br />No <br />Permit Postec!,: ; No <br />Reinspection on or After: <br />/i <br />S S r¢El P 1o <br />a r oN <br />s <br />oAn'Q- <br />' Item/LOcation <br />Temperature <br />Item I Location dre. <br />Food Safety ce.. <br />' _ <br />Facility Hot Water Temperature <br />Warewa' <br />Chlorine: ppm Heat: 'F <br />Name: <br />Hand Sink: <br />'F <br />Exp. Date: <br />arewashing Sink: <br />eF <br />uat. Amm.: Ppm <br />IP <br />Other: 'F <br />Received By/ Title: <br />- <br />EH Specialist: <br />Phone: <br />ime in: <br />Time Out: , 5 Page <br />EHD 16-24 (2n°pg) 4/3113 FOOD PROGRAM OF CONTINUATION <br />