Laserfiche WebLink
,oP"•.s,G SAN .JOAQUIN COUNTY <br />y� ENVIRONMENTAL HEALTH DEPARTMENT <br />m 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />G1Fda� <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: ID <br />Q <br />15 <br />z' o T FT <br />Date: <br />IV 191W <br />Address: <br />Zlp Code: <br />t 9 F <br />Owner/Operator: <br />Telephone: <br />Program Element: b <br />Program Record:5 <br />'Z <br />Inspection Type: <br />0L -1-r INY, <br />B180 Posted Yes No <br />Permit Poste Yes No <br />Re -Inspection on or After: <br />%.fC� L 11W_ /r/. ✓lid _4- — /_ e4%"b - -t?j YJ19. 4 <br />EHD 1&24 (2 -pg) 4013 FOOD PROGRAM OIR CONTINUATION <br />V U <br />h <br />Item/Location <br />Lure <br />i.o� "- „ <br />i e r o Cure <br />_ Footl Safety Certification <br />Name: <br />Exp. Date: <br />Facility, Hot Water Temperature <br />Hand Sink: <br />arewashing Sink: <br />of Chlorine: <br />F Duet. Amm.: <br />'- Warewashing <br />ppm Heat: 'F <br />ppm Other. °F <br />Received By / Title: �N3 <br />EH Specialist: <br />Phone: <br />Time in: <br />Time Out: <br />Page of <br />EHD 1&24 (2 -pg) 4013 FOOD PROGRAM OIR CONTINUATION <br />