Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> r. .y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> . a.., ;p• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sdgov.org/ehd <br /> A��FORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: A ate: <br /> Address: City: V e Zill Code: --:5 21 J <br /> ,� <br /> kcaOwner/Operator: Mwn " �n Telephon �/V <br /> Program Element: Program Record: � � lJU inspection Type: <br /> SB1 30 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 1 [_t—ir <br /> 1A a-;?� <br /> 10AaM On <br /> boOi a . <br /> i <br /> 4 <br /> ►� n - � <br /> Item/Location I Temperature 1 item/Location Temperature <br /> Warewashin <br /> Food Safety Certification Facility Hot Water Temperature _ g <br /> Tempera Heat: <br /> _ Chlorine: °F <br /> — - Hand Sink: �F ppm <br /> Name: <br /> Exp.Date: arewashing Sink: �F Quat.Amm.: ppm Other: �F <br /> Received By/Titl <br /> EH Specialist: Phone: `o <br /> ime in: Time Out: Pag f <br /> FOOD PROGRAM OIR CONTINUATION <br /> EHD 16-24 (2n1 pg) 4/3/13 <br />