Laserfiche WebLink
SAN JOAQUIN COUI`. <br /> P • <br /> 2. ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.s*gov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: y Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: p„ 1� Telephone: <br /> Program Element: w ' Program Record: ® Inspection Type: <br /> 6180 Posted ❑Yes ❑ Rermit Posted ❑Yes ❑I Re-Inspection on or After: <br /> Wi=l MR <br /> _ e ei <br /> ®t,P Y► d`f 4V BY7 <br /> rue <br /> 7 d P �Gc s <br /> To r_7 <br /> JIMA <br /> .dam <br /> aU o1-II-U <br /> u�- rave-t I'11e1� <br /> CA <br /> ZA <br /> tr�w�e-�i <br /> Item/Location I Temperature <br /> ._........_......... <br /> — <br /> ttlfiLatn i`actl►ty riot Water temperature y _ <br /> Name: Hand Sink: F Chlorine: ppm Heat: °F <br /> Exp.Date: arewashin Sink: of Quat.Ani ppm Other: of <br /> Received By!Title: <br /> EH Specialist: Phone: _Vof_ K <br /> Time in:Of <br /> 1�(✓ - Time Out: Page 1013 <br /> EHD 16-24 (2n0 pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />