Laserfiche WebLink
Q�a " SAN JOAQUIN COUNTY <br />? ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />• cq ;iFOR�;a. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: F V I 5rouiI <br />Date: <br />Dir -05 <br />-2 - <br />Address: City: <br />Zip Code: <br />Owner/Operator: <br />Telephone: <br />Program Element: Program Record: <br />Inspection Type: <br />Re) <br />B180 Posted Yes No Permit Posted Yes No <br />Re -Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />NO r/{jW bL/OTtbNs <br />q -7 . d. T IA <br />R 61'6 <br />S <br />No -r <br />ON <br />/ <br />ra <br />Item/Location Temperature I <br />Item / Location <br />I Temperature. <br />/— <br />' - Food Safety. Certification jI Facility <br />-. <br />Hot Water <br />I <br />.*----- <br />Temperature " " Warewashing <br />' <br />A <br />Nap e: Al �Warewashing Sink: <br />Ex Date: (Hand Sink: /00 <br />.F <br />F <br />Chlorine: Ppm <br />Ouat. Amm.: PPM <br />Heat: <br />11 <br />�F <br />11 Other: <br />"F <br />Received By/ Title: <br />EH Specialist: Gi—A .�% Q� <br />Phone: Z69 <br />ime in: / s`Z p <br />Time Out: Z i Z <br />p <br />Pag2 <br />es of <br />EHD 16-24 (2° pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />