Laserfiche WebLink
a4"'" SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />(4� <br />, Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />�IFORN <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />ame of Facility: <br />cow f <br />Date: I 2 - <br />?-t <br />ddress: 2 <br />MA*N_ City: <br />Zip Code: <br />wner/Operators; <br />ludcf J <br />Telephone: <br />Program Element: <br />t Program ecord: O S d <br />Inspection Type: <br />8180 Posted <br />Yes ❑ Rerrnit Posted Yes ❑ t <br />Re -Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />y- Ak <br />UJ <br />dt r <br />i"- - V( b.✓ <br />!� <br />J� <br />a <br />IS <br />✓ <br />iw <br />NAA ✓ <br />K <br />✓ <br />A4Ak'j <br />vu J [MYK_ d I waym wwtp <br />(S W_ �vL <br />`I VW S <br />Vi vv" WLR <br />Vwtnat VVVLAWL <br />�— l �-- <br />►�ti9d <br />%rr Gt�2 [a ✓iVt <br />v1 <br />Uv. 1 C (� U✓ur4— <br />Item/Location . Temperature Item/Location <br />_ r <br />3 RF <br />ptntiW—i <br />Food Safe <br />Name: <br />Certifica io1 <br />1 <br />I <br />Facility HoCWater Temperature/ Warewashinc�" <br />Hand Sink: Chlorine: Heat: <br />,F S � ppm <br />of <br />Exp. Date. <br />�I <br />arewashing Sink: 'F rther: <br />uat. Amm.: PPM r <br />'F <br />Received By / Title: <br />WlYJeh /- `, <br />` <br />- <br />EH Specialist: <br />TTime <br />Phone: <br />Cl lJC ! R CU , UI _(i <br />V' <br />in: <br />Time Out: <br />Page 2-0f ? <br />EHD 1624 (2n P9) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />