Laserfiche WebLink
City: <br />Telephone: <br />Program Element: <br />Permit PostedSB180 Posted <br />rH <br />iu\ <br />- aU KA <br /> <br />Item / LocationItem/Location <br />Chlorine:Name:Fppm <br />Warewashing Sink:Quat. Amm.:Other:Exp. Date:°F PPm <br />EH Specialist:Phone: <br />Time in:rv\ <br /> <br />VW - (oo <br />- <br /> A- <br />o <br />c <br /> <br />G <br />0 <br />tvi i/rV ■ i Yui l^r- <br />V~s e <br />^<4 <br />(lw*-Vx <br />Warewashing <br />Heat: <br />McCo^ <br />Program Record: <br />^wo m v <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />vRz - \ (7^; <br />MIT <br />Page^ of <br />FOOD PROGRAM OIR CONTINUATION <br />Temperature <br />^i“r <br />S^VV' <br />Food Program Official Inspection Report <br />Vttk Date: <br />c"»: ziPCode: <br />Yes No <br />_J _ <br />°F <br />Temperature <br />ley <br /> IxX <br />I <br />Facility Hot Water Temperature <br />Hand Sink: op <br />C <br /><h vsrsG <br />WtA/Xz- — <br />Ly QZ <br />■-? v-’T <br />3 XCA.YV, <br />"L I'lSr 71^ <br />Time Out: U qj <br />T/u^ <br />Inspection Type:^ <br />Re-Inspection on or After: <br />San Joaquin Col y <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 />5 dM a ^3__ckuryrJ^ c <br />Lr t- feKr <br />01^ t w— <br />- <br />1 nrr <br />__AyrlIpV <br /> <br />M » Vci^vx LPO^CA^ <br />HL YMlCvu-VV S^VXA <br />Food Safety Certification <br />Received By / <br />\ - 'IS) Ova <br />EHD 16-24 (2nd pg) 4/3/13 ' <br />Name of Facility: $a.a <br />Address: ugb < <br />Owner/Operator: z Lj, <br />ika5L_ <br />Yes No