Laserfiche WebLink
SAN JOAQUIN COL Y <br /> X ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • •.. r. Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sugov.org/ehd <br /> 4L�FOka <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: r I Date: <br /> Address: ('105 j, 1 0 r��v City: 5_L _�.V r1 Zip Code: 9,5�0'? <br /> Owner/Operator: �L�/`+ P 1.. ; TTJ Telephone: <br /> Program Element: I i0 u� Program Record: I /_2 g Inspection Type:"�V 'Y7 <br /> 8180 Posted/-es No Permit Posted Xyes No �P Re-Inspection on or After: / -/Y <br /> n i• �'t n d(-� u of-E. 1 r 1 77W <br /> rn& a e <br /> U <br /> 0dt r -e- s <br /> ri <br /> _Dfski 50an o e C_ , <br /> 61-,4C- O Lj C) <br /> n i '7.e r v -2e ro —Gtr S i . LA_114 <br /> Y A-P- r aAlkFF <br /> %M_L <br /> �- i n O ' <br /> n ri' Y"a1 <br /> a V' Foe> d ia4n Lk vTr•e <br /> rr CIA-r o�-D d-a V- ima <br /> C c r 0 4= C-.2 <br /> 2uJ-r <br /> D 4v ✓ c> Q <br /> .c CO •^-& - <br /> h+ v_e r - ?ro V f 10 ! - 2 C cJ A-&-(C <br /> G '0_ • rr1 r vy n so✓ z <br /> ' r <br /> JM CI <br /> V G--4 rG 11� Cit 1.f !J1 r Ih< F <br /> Item/Location Temperature Item!Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> - _-........-------..__....----....__.._ _.............. ---. --- — - ---._...._..._.__.._......__...... <br /> Name: ur Hand Sink: /�-7 oforin • .20&PPM Heat: of <br /> Exp.Date: _f _J arew shiSink: ,LO *F Quat.Amm.: �p� PPM Other: 'F <br /> K ''( <br /> Received By/Title: <br /> EH Specialist: e�� Phone: <br /> Time in: / O V . Time Out: a SOS Page�f <br /> EHD 16-24 (2n'pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />