Laserfiche WebLink
aP`�g'"•• SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />r4�lFdR�,a Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siaov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />a <br />Date: 1 r I •7– <br />ddress:T <br />City: <br />CAl <br />w f Zip Code: ! .? <br />r V <br />Owner/Operator: <br />Telephone: <br />Program Element:Program <br />Record: <br />15 <br />Inspection Type: G ti / <br />SBI80 Posted a No <br />Permit Poste a No <br />Re -Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />C <br />WPW <br />Ut-4 <br />r <br />VAN v� <br />L� <br />&11 t62 <br />1 /`iota <br />ItemU6e eon <br />Temperature <br />Food Safety_ Certification Facility Hot Water Temperature <br />Name: Hand Sink: <br />_ Warewashing_ <br />`F Chlorine: ppm Heat: 'F <br />Exp. Date: <br />Warewashing Sink: <br />"F Quat. Amm.: PPM Other: 'F <br />Received By /Title: <br />IEH Specialist: C <br />t1 14 Z> G— A n tj <br />Phone: <br />ITime in: Time out: rage or I <br />EHD16-24 (2^dpg) 41313 FOOD PROGRAM OIR CONTINUATION <br />