Laserfiche WebLink
SAN JOAQUIN COUNTY <br />Q` a ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />•.. ;a Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.s'gov.ora/ehd <br />4CiFOR� <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />l/ ' <br />Date: <br />ddress: <br />City: <br />Zip Code: dL <br />Owner/Operator.— <br />l i <br />Telephone: <br />Program Element: <br />Program Record: <br />Inspection Type: ' <br />6180 Posted Yes No <br />Permit Posted es No <br />Re -Inspection on or After: <br />F <br />EHD 1&24 IV pg) 4/3%3 FOOD PROGRAM OIR CONTINUATION <br />OBSERVATIONS AND C RRECTIVE ACTIONS <br />p <br />� <br />- <br />12-b F <br />Food Safety Certification <br />Name: <br />Facility Hot Water Temperature <br />Hand Sink: of Chlorine: <br />ppm eat: of <br />Exp. Date: <br />arewashing Sink: of uat. Amm.: <br />ppm that: 'F <br />Received By / Title: <br />_ J <br />EH Specialist: <br />Phone: <br />_ %JDEKD <br />Time In: <br />Time Out: <br />PagtS�of <br />EHD 1&24 IV pg) 4/3%3 FOOD PROGRAM OIR CONTINUATION <br />