Laserfiche WebLink
Rauln., SAN JOAQUIN COUNTY <br />a` ? ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />�4r/Fdar;p Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siaov.oro/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />ame of Facility:e \ <br />Z C-0 Date: I. _ <br />ddress: 5� �� \ <br />Cit . rC^C. Zip Code: R S 3� <br />Owner/Operator: <br />Telephone: <br />_ 1 Program Record: ` b I S 2 Inspection Type: ` <br />Program Element: \k <br />8180 Posted Yes No Permit Posted <br />Yes No Re -Inspection on or After: <br />BSERVATIO, IYE CT1ON :• <br />\ Or-4P_0,A 42 e'S gid\ C.o.. l e <br />� e I <br />\3 sl t c2 <br />zG \e Z-2_C-ks-aP A:_ <br />-ESC �� <br />5\tLeS <br />e <br />k i✓N d c1L d r1 <br />5 r l 15 t= <br />\ c.0 mod -51 <br />\ Z- of <br />d Treeof e 12y 0 F <br />A-� <br />\ 1�a �i,z.,✓. <br />w.r .\ �R 3d Av 11= <br />" perature - <br />3`t - �s��lza�ed cheeses ��- <br />re h o. <br />`{� F <br />2 d� r - cheese 3� <br />c <br />3-1 F- <br />\3b F <br />\'90 <br />2c1— r S F <br />Facility Hot Water Temperature <br />Name: Mar D M _ Hand Sink: I LqD`F <br />` <br />Chlorine: PPM eat: o f <br />Exp. Date: r _ , 3 , 2 5 <br />arewashing Sink: `2� F <br />Oust. Amm.: '200 n. PPM theof <br />Received By/ Title: <br />.n <br />EH Specialist: <br />VPhone: 2O� , b 1 Jl� 5 <br />ime in: <br />Time Out: `, L Page of <br />EHD 1624 (20 pg) 4/3'13 � t FOOD PROGRAM OF CONTINUATION <br />P� <br />