Laserfiche WebLink
Food Program Official Inspection Report <br />Date: <br />City:Zip Code: <br />Owner/Operator:Telephone: <br />Program Element:Program Record:Inspection Type: <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />__ <br />) <br />1 v <br />TemperatureTemperatureItem I Location <br />i <br />Name:Chlorine:°FPPm <br />Warewashing Sink:Quat. Amm.:Other:Exp. Date:°FPPm <br />Received By / Title: <br />Phone: <br />Page ofTime Out: <br />FOOD PROGRAM OIR CONTINUATIONEHD 16-24 (2"»pg) 4/3/13 <br />l.J-3 <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.orq/ehd <br />Name of Facility: <br />Address: <br />Warewashing <br />Heat: <br />___ <br />EH Specialist: <br />Time in: <br />_________ _______ <br />Food Safety Certification <br />Item/Location <br />°F <br />Facility Hot Water Temperature <br />Hand Sink: op