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.sigov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: (Ayil cte (0 rn t e- t <br />Date: 4) ).,--/ . iv <br />Address: t ap .. C...7)1 VA \I inA 1,,,N) City: C,_.ltpc,,OD.K) Zip Code: bicw) <br />Owner/Operator: p.,lot <br />i ine- ne .?-7. Telephone: p <br />S Program ElemenA4 • Program Record: • Arelperr. a eg. Os L S ( pection Type: ,;,sgrga, i i .. rad Rs.) 0 <br />9 SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />ic_e. Cf/0 no_ _ semew4 ,07-,w4c/veto vou <br />voquvu m- v., s-vvA,t, oma_ <br />PupePtOacy_ T'-oM ocnis- -110 or-0 t Ths po-- -hryt <br />-Or--51- 4 s0 c ter <br />0917tin riKA- te 0e'- co pq b \90,111,4 <br />) \ r e OM . n 0 rlaior VA*Inc& <br />n b e (-A tm. risq9 <br />\MAI vi2. e a, vai i-P- leti rn AA/VeJ• 02 ,s rIO 01 <br />V-te LI 117)2 CI ,4_170 & 071*-71 &i-- <br />NAVA/ P c r) e cC-7 1 <br />Temperature Item/Location Temperature Item / Location <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: o F Chlorine:Heat: PPm <br />0 <br />Warewashing Sink: c Quat. Amm.: PPm Other: 0 Exp. Date: <br />Received By / Title: <br />EH Specialist: A t7 /,4/ <br /> <br />Phone: <br />1 <br />Time in: ,1 ., 27 )7 m a-) Time Out: . (A tA ck m Page o <br />EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION