Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> xat�e'�o <br /> a` ?� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> {Y/Fda�;p Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: (�' I1V) Ic] -ji�� Date: <br /> Address: ail) City: _ ) / Zip Code: Sa <br /> Owner/Operator:_' /ul� �n Telephoner 33 V^ 151S <br /> Program Element: ' (03 Program Recor !)� OS 80 3 Inspection Type: r�W!-h�l <br /> B180 Posted Yes No Permit Posted es No Re-Inspection on or After: <br /> • -BSERVATIONS AND CORRECTIVE ACTIONS <br /> *- tarqgbke <br /> Issue CS a.c <br /> 'ocation INWerature Item Location "'- „erature <br /> Food Safety Certificatl :ecillty Hot water Temperature Warewashing _ <br /> Name: and Sink: 'FChlorine: PPM Heat: of <br /> Exp.Date: arewashing Sink: of uat.Amm.: PPM ther: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: M Time Out: �, i /sem IM,7 Page/of ii 'i <br /> EHD 160°24 (2pg) 413113 'T FOOD PROGRAM OIR CONTINUATION <br />