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.sjciov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: .)i. v-ii (jo(y. tt n c_c_rrii- -tep, 1--itriu4s ii 1 :4- Date: <br />Address: L\cy- ---)• -k iktie-, City: C3trc /c--4\..) Zip Code: _ /I <br />Owner/Operator: <br />1 pi,t _3 <br />Telephone:i) 1 3._ __: 9 O. <br />Program Elementi Program Record: VD,c1Ct pe yjl A._ Li(c, o(A6nspection Type: th,taii11.-tni ..A.... <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: (- <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />‘.xc an al -\91w.w...4)., <br />C) skplicAmay , ounic) (0+ ill2•01) <br />1j) CAVISTACAn '111.1111Li A:;i1j2rn - rre)19/1Cr-j4 0111L4 nt-) (i'otriip1ar9 <br />4c'C'i') Nir 1 1 -'cillitY1 - pyucl Lire i <br />I nur\O -A,arn-11 Li •aoirn c - vacluc'e- s........, <br />\f\faAA 0-4- LA, litataS. -- <br />..). <br />a 3 4--L) gel,trrip , ,irri . - piviLt (4? a ' <br />Le? _.....3 ,c, uun 1 nc rue-A Li (.Q , p <br />i .....-- <br />77 6 +12-Qgb'il... 42----rn- pnxiiia).. <br />..,-- _ __ _,--,,, C\Lwal- .1-yee -t---xvins ---pitz4Aitce ........- <br />1 -r-ittitn, --/TA) 62 <br />... <br />Food Safety Certification Facility Hot Water Temperature Warewalhing <br />Name: Hand Sink: o F Chlorine:Heat: PPm °F <br />Exp. Date: arewashing Sink: .F Quat. Amm.: ppm Other: °F <br />Received By / Title:- ) - , 1 , j-,.._—, <br />EH Specialist: <br />--; — ate g._ Phone: <br />Time in: , rA, cit, Time Out: Page3of (1 <br />EHD 16-24 (2^d pg) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION