Laserfiche WebLink
aP°'g'N••.F SAN JOAQUIN COUNTY <br />r• � P <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />.. `p Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sioov.orolehd <br />cr�eNr'�` <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />Date: <br />' tJ 2 <br />Address: a✓C { <br />v� <br />L CRY: Zip Cade: <br />Owner/Operator: <br />Telephone: <br />Program Element: Program Record: aO O Inspection Type: <br />O <br />SB180 Posted Yes No Permit Posted <br />Yes No Re -Inspection on or After: I <br />.z S /.7�'r3 <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />- — eco <br />i9 vt�v- n ✓� s - <br />/e� O`f� <br />a" C1 � <br />4 rev <br />Item/Location <br />Temperature <br />Item / Location <br />Temperature <br />4 L 5 <br />- F <br />Food Safety Certification <br />Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: 'F Chlorine: PPM Heat: <br />`F <br />Exp. Date:arewaashing <br />Sink: of uat. Amm.: PPM they: <br />'F <br />Received By/ Title: �$�US ✓ <br />e4 �� l../d•rt� �Q. - <br />EH Specialist: /' _n <br />^t_9 <br />Phone: — 411 — <br />Time in: Q ; e�0 <br />Time 2 Out: ' r M <br />s Page Of <br />EHD 16-24 (24 pg) 403 FOOD PROGRAM OIR CONTINUATION <br />