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SAN JOAQUIN COUNTY
<br />ENVIRONMENTAL HEALTH DEPARTMENT
<br />600 East Main Street, Stockton, CA 95202-3029
<br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.orq/ehd
<br />
<br />P:10L-
<br />#00,13 ROGRAM OFFICIAL INSPECTION REPORT
<br />Name of Facility: Lle/400-1;it- 4 Date: 7/03ki
<br />Address: /(C) A NE e,,, City: Zip Code:
<br />56 2/0
<br />Owner/Operator: . Telephone:
<br />Program Element: Program Record: Inspection Type: 1/61..3 Lo
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<br />Item/Location Temperature Item / Location Temperature jem I Location Tempe
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<br />114
<br />Food Safety Certification -Facility Hot Water pera,ture Warewashing
<br />Nam...e.:>_----- Hand Sink: . Chlorine: ppm Heat: °F
<br />irlii. Date: - •- ing Sink: . Quat. er: °F
<br />Received By! Title. L
<br />EH Specialist:Phone 4. s ) 4;q ,. Ds .3.,,,f
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<br />j ime in: Time Out: Paefof 2
<br />EHD 16-23 (2'p g) 11/06/08 FOOD OIR CONTINUATION
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