Laserfiche WebLink
SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: Date: <br />Address: <br />‘ \ -4- ...'. e"\-1\ (-) i City: Zip Code: <br />Owner/Operator: Telephone: <br />Program Element: <br />VoY)2_ / , ''f -7 -1 ci j '.S 1 icl --- <br />Program Record: Inspection Type: <br />-3 "0.-...:•k-ci---C i <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: • <br /> <br />'\o Gro,(00-QcAvoi ' ' '6 .'%?.(31 f---Q-"_)- --,---fri, t e-• c <br />A .../SL----k2-\A-N - ..).icy,...v(v.‘ -..i._) c.^)-e--, k 0-1-).- I CM i•=-- ('.-L4 <br />i c - ) -'---i2-Q • -.-1/4:::k_As.--La..S.4-z_ \<-) .__)c -4 (_12 71-- -P-, ... , , ),..---1. -,1-_Q 0) rt ----ip •--‘-‘olLt? k.) <br />, i , n <br />/•--,- i c-...c._.-,(-----.1 /4 •--r--A i J cr.....,; r c--_ , <br />i -----s•Ls-,) c.../l...,1/4.1/4-1., 1 /4.- ..,----Q._ <br />P -170,..z. c....c, 9.,,St. 0 Q : <br />A-If -.--,`s <br />D c----0--- ck <br />11--...c2,-...Q.. <br />, , <br />- Item/Location Temperature <br />Facility Hot Water Temperature Warewashing <br />Hand Sink: o F Chlorine: PPm Heat: ., <br />Exp. Date. arewashing Sink: .F Quat. Amm.: PPm Other: . <br />Received By! Title: --11.U0 r-alto... <br /> a 94A-) <br />EH Specialist: Phone: 2 -.0 b _ <br />...4.-NVI CV"---9-2_ . . c4aes...t--4-0- (7)) <br />Time in: e..,"4---' ..3 lime Out: S2 Pagtiof i ' ok ( <br />EHD 16-24 (2^° pg) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION