Laserfiche WebLink
SAN JOAQUIN COU, <br /> 0: XX ENVIRONMENTAL HEALTH DEPARTMENT <br /> - _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �4..,• a...�;�P �e <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> <«o a <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: wjA�Y <br /> Date: 1-5-16 <br /> Address: 5 a 4 4-h4, `X' cl <br /> City: C't- Zip Code: g2'6 <br /> Owner/Operator: 6?Ls r a r i I_ Telephone: 9� _ OZ <br /> Program Element: b 2 Progra Record: /� r� / Z 7 Inspection Type: ; <br /> SB180 Posted Yes No Permit Posted es No Re-Inspection on or After: <br /> k } X C?BSERVATJONS`AND CORRECTJVE ACTJC3NS , <br /> . ��....� - <br /> [b_ ho+ leo-� -e 1 cf-F 1150T. cl�+.�s + <br /> o r _ _ _.. ._Y_ .. --- <br /> Q.......1 -}.. .-Q-- -� .._. ._u_A.._►' a5............_........ rl ____. ................................... I.--- I v� <br /> Gt v s-�- I _ lam-CA n ........._1_. 1 <br /> r -4y <br /> Yri40 L10 r-) Y Ot.%r QY� Y`14-12 La <br /> Vh cLr a , <br /> it ! r ✓14 S L2 4 '"e- no+ <br /> D Y1 �&4 4f ro cr1 d-Q- ov, <br /> ltemiLacatran Tem erature Item/Location = i Temperature <br /> �. . <br /> k. P <br /> a _ - <br /> >`opi Sats Gertifir, ton ¢ aril Hot YYafer Tem rature Warewashing <br /> F <br /> l� <br /> dl'_ <br /> Name: Hand Sink: of Chlorine: PPM Heat: of <br /> Exp.Date: az=: f of Quat.Amm.: Poo Ppm Other: -F <br /> Received By/Title: <br /> EH Specialist: 9 ki,, Phone: <br /> Time in: O• )/, (I vv 1 Time Out:`��—�— Pag9 of l <br /> EHD 16-24 (2ro pg) 4/3113FOOD PROGRAM OIR CONTINUATION <br />