Laserfiche WebLink
SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: I V -9 65K *105%7c <br />Date: 2—Z <br />Address: I p`,I.�v E�S <br />zip Code: ' <br />Owner/Operator: M ►NG�N <br />Telephone: <br />Program Element: Program Record: 17F-6 r <br />7 <br />Inspection Type: Ap . <br />w�l rl ore, <br />SB180 Posted a No Permit Posted Yes No <br />Re -Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />No V; OLAT-tON$ Itewrl"e7E0. <br />Okla y TO 155 u E 20 7-3 t'T ON . <br />L c+ 32 C- <br />Item/Location Temperature <br />Item I Location' "' e <br />Food Safety Certification Facility Hot Wafer Temperature <br />Name: n/ Hand Sink: <br />Exp. Date: warewashing Sink: <br />F Chlorine: PPM Heat: "F <br />'F oust. Amm.: ppm ther: .F <br />Received By/ Title: <br />EH Specialist: ILL A) ROr <br />Phone: 7-p <br />Time in: 5 A K4 <br />Pag!Zof <br />Time Out: 43:3U AM <br />EHD 16-24 (2 -pg) 413/13 FOOD PROGRAM OIR CONTINUATION <br />