Laserfiche WebLink
SAN JOAQUIN COUNTY <br />t ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />�a :iFOR�;P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sioov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: —T -A f /°1 /,-,1 1/1( !I k U- i L] : -,�4 Z . Date: t 4)d3 <br />Address: i�-1 `I <br />w — <br />City: <br />Zip Code: <br />CJ <br />Owner/Operatto`r: wt%. <br />Telephone: _ <br />Program Element: <br />Program Record: 19 <br />Inspection Type: <br />B180 Posted Yes <br />No Permit Posted Yes No <br />Re -Inspection on or After: N j r4 <br />RV TIONS AND CORRECTIVE ACTIONS <br />rre <br />m� n, <br />IIIIIIIIIIIIIIIIIIIIF�food Safety Certification <br />Facility Hot Water Temperature <br />Chlorine: <br />Warewashing <br />PPM Heat: of <br />Name: <br />Hand Sink: `F <br />Exp. Date: <br />Warewashing Sink: <br />-F <br />oust. Amm.: <br />ppm Other: =F <br />Received By/ Title: <br />EH Specialist: <br />Phone: i <br />Time in: <br />Time Out: <br />/f Inn Page i of <br />[ilii f f <br />EHD 16-24 (2-P9) 4013 FOOD PROGRAM OIR CONTINUATION <br />