Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> p 2a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s' ov.org/ehd <br /> �lFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: ) r <br /> Address: City: n Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: 6 4 Program Record: � Z Inspection Type: � <br /> S81 BQ Posted Yes No l Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> r ' <br /> dYI2 Pup ryl <br /> 1�2 le <br /> r <br /> c ° <br /> c <br /> i <br /> c <br /> t IL ki In <br /> r <br /> • <br /> Item/Location Temperature Item I Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: r Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: °F Quat.Amm.: ppm Other: 'F <br /> Received By 1 Title: <br /> EH Specialist: Phone: r �/ <br /> ime in: r7 o Time Out: Q ^� f� Page of _ <br /> r <br /> EHG 16-24 121'pg; 413113 7000 PROGRAM OIR CONTINUATION <br />