Laserfiche WebLink
Zip Code:C'ty: <&vrM <br />Telephone:Owner/Operator: <br />Program Element: <br />Re-Inspection on or After:Permit PostedSB180 Posted <br />•X/ <br />a {0^ <br />fl <br />( <br />1 <br />-a- <br />I TemperatureItem / LocationTemperatureItem/Location <br />Food Safety Certification <br />Chlorine:Name:Fppm <br />Other:Warewashing Sink:Quat. Amm.:Exp. Date:°F ppm <br />T <br />Phone: <br />Iw Pag^of <br />FOOD PROGRAM OIR CONTINUATION <br />. OhI_ ftz <br />Name of Facility: <br />Address: <br />tnm> i"VP <br />Gt _____ <br />(AV $ <br />Warewashing <br />Heat: <br />°F <br />Program Record: <br />Yes No <br />Food Program Official Inspection Report <br />Date: <br />(7 <br />Timeout: g . <br />Facility Hot Water Temperature <br />Hand Sink: op <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 />US' <br />Yes No <br />Oibc^ H e, nrr <br />Inspection Type: <br />V'iV'lA _% <br />I" Ov ~ <br />“ t <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />^lu/^ Iz4 yF <br />__________________________ __________________________j <br />fcyflA 6flbZVfpM>Vv Irlvv^' S<Ap1^7»'K d <br />tAn <br />—‘finS_y_____ ____ <br />’ *- ceMtryr^- ^3° __________________ <br />$<^<4 ThA< Cae/(z^ 6 ____ <br />'hiz^ <br />Received By / Title: <br />EH Specialist: ~y^, <br />rimein: <br />EHD 16-24 (2nd pg) 4/3'13 \