Laserfiche WebLink
Item / Location <br />Food Safety Certification <br />Time in: <br />Name: <br />Exp. Date: <br />Chlorine: <br />Quat. Amm.: <br />J Temperature <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.org/ehd <br />jA r- <br />Page |of <br />FOOD PROGRAM 0IR CONTINUATION <br />Program Record: <br />Permit Posted <br />\ â–  <br />MO <br />Warewashing <br />ppm l01^ <br />°F <br />°F <br />___________|| <br />Facility Hot Water Temperature <br />Hand Sink: op <br />jWarewashing Sink: °p <br />Phone: - (Q |f 0^^ <br />Time Out: P <br />J <br />Eisz: <br />4 <br />I <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />a - H / 4 - -wtq <br />ir <br />Received By / Title: <br />EHD 16-24 (2nd pg) 4/3/13 <br />ot-icpppm <br />ivLiim to <br />,lg,-tto£Temperature <br />r—» -SaAlJv'^ <br />(i rtto w W <br />_2DO)- Bj <br />MotrtJZn £|2rw i <br />(Io)jAiaY I ifoK- <br />Item/Location I | ’ <br />_______ Food Program Official Inspection Report <br />Name of Facility: l , Pate: IP/'T/S-'S ~ <br />Address: Xl'g 11WWf fl zip c°di::/ ~ <br />Owner/Operator: P. ' , \ Te'ePh°ne: <br />Program Element: Program Record: Inspection Type:f <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: ‘