Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • .., iP• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd <br /> 4Gf FORA <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: r Date: <br /> Address: '"1 5 1 e J e SjCity: l /-� Zip Code: 3 <br /> Owner/Operator: Telephone: <br /> Program Element: 1 1 1 S Program Record: l `_ ��3 Inspection Type:C <br /> 1, �V v <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> C2 0 <br /> c <br /> \ .^.* CA S er e d <br /> -F <br /> l e ss <br /> �5 5 tet ' 21 - 23 - 2- 2 <br /> ing, d - 2,\4- Z <br /> ation Temperature Item/Location <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: `F <br /> Exp.Date: arewashing Sink: o f Quat.Amm.: ppm Other: 'F <br /> Received By/Title: <br /> EH Specialist: 1 Phone: <br /> Time in: Time Out: Page Iof <br /> EHD 16-24 (2otl pg) 4/3/1N FOOD PROGRAM OIR CONTINUATION <br />