Laserfiche WebLink
SAN JOAQUIN COU, t <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1 868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> + rq•., �;;P• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s ov.or /ehd <br /> �7Fiid <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: J Date: ct 3—I <br /> Address: City: Q , Zip Code: S <br /> Owner/Operator: C �f Telephone: <br /> Program Element: , q Program Ffeeord: 5 2 Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ,ACTIONS <br /> — <br /> h 53 I= <br /> `�- \3 S—' r> e <br /> —F c Q c1A �S I F 8z�zA m lse L o <br /> W b E 4__1_)> 6,-) r <br /> y L — <br /> ��.�- <br /> ftem/Location •Temperature �� Item I Location Temperature <br /> � _ - <br /> ooti 5afet Certification_ y ;i Facility Hat Water Temperature '; Warewashing <br /> Name: - — — - -- - (Hand Sink: - -- -- F Chlorine: - ppmF- <br /> Exp.Date: !warewashing Sink: �F Quat.Amm.: ppm �4Other. ,E <br /> Received By I Title: F <br /> EH Specialist: Phone: ll b <br /> ime in: time Out: q Paget oS <br /> a 1 <br /> EHD fo-24 (21 pg} 4013 FOOD PROGRAM OIR CONTINUATION <br />