Laserfiche WebLink
POUI/y <br /> SAN JOAQUIN COL rY <br /> Y' 2 <br /> a: . ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> �4�icaa'N p Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:—www.siqov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> fNameFacility: Date: o o3(;P _c am City: �� Zip Code:perator: -m Fe <br /> Telephone:lq ti�-az4, <br /> Element: Progracord: PR O52-73CoCp Inspect ion Type: �>1�A-e— <br /> sted Yes ❑ No Permit d�Yes ❑ No Re-Inspection on or After: <br /> D C WE ACTIO <br /> 0 <br /> n4 u 4.s W� a4 <br /> O r LL/ r / T85P <br /> rx <br /> 2 / <br /> OI S C-O verS r <br /> -5->`1..o 7 �o f Waw✓ ro v-+l¢.- UJ12 e r D <br /> C4-4'P!! 7 ry L !n-r'A z- <br /> �� f rOVC <br /> ;Date: <br /> 3tor-a B 2gor I Le l�/5 and Sink: /a I 'F hlorine: ppm t 'F <br /> a_ _/3 Sink: -F uat.Amm.: ppm ther: -F <br /> v <br /> Received By/Title: <br /> NSpecialist: Phon : G?53 -? / <br /> !me In: Time Out: '� ,/ Page-,of? YO 2 <br /> EHD 16 <br /> 24 (2-Pg) 11t20 FOOD PROGRAM OIR CONTINUATION <br />