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Zip Code:City: <br />Telephone:Owner/Operator: <br />Inspection Type:Program Record:Program Element: <br />Re-Inspection on or After:NoYesPermit PostedYesSB180 Posted <br />TemperatureItem / LocationTemperatureItem/Location <br />Food Safety Certification <br />Chlorine:°FName:ppm <br />Other:!uat. Amm.:Warewashing Sink:°FExp. Date:°F ppm <br />Received By/Title: <br />Phone:EH Specialist: <br />Page ofTime Out:Time in:- <br />FOOD PROGRAM OIR CONTINUATIONEHD 16-24 (2nd pg) 4/3/13 <br />OBSERVATIONS AND CORRECTIVE ACTIONS <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.org/ehd <br />Name of Facility: <br />Address: <br />Warewashing <br />Heat: <br />Food Program Official Inspection Report <br />Date: <br />No <br />Facility Hot Water Temperature <br />Hand Sink: