Laserfiche WebLink
SAN JOAQUIN COUN <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 0: X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: j C4 TO z &4. pqgj! Date: J2- It-Iq <br /> Address: f r C�'qCity: -Fro ir Zip Code: <br /> Owner/Operator: Ah: i Yp4v Telephone: r3k,& -7 3 <br /> Program Element: broo Program Record: COOO 3 r911 Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> rA 111 .(A D SIC41f3l PJ 0 9 1OVe-S C Z--15 Ld Pit., k an dl- <br /> dI - ;�_ //- /q <br /> ' <br /> 4 e so 'vf <br /> Jo- V.,dS. aist1d <br /> ".C, cn_ >Zq Q t'15 JS And a' <br /> b ol re, _A�j, -1......................... <br /> 10 po <br /> j <br /> S; T e. Vi I Cc,V k5 W11 a r.*j%f wls 1i Me Of i <br /> Ll <br /> Lcy w e#r&'f;)'fj oil Al 1/42;Z fr%X baro h&Al cc,, I ac �e <br /> ..................... ............... <br /> ...................................... ... <br /> ............................... <br /> Item/Location i��erature Item I Location 1 Temperature <br /> ............................... ------- <br /> .......... <br /> Food Safety Certification 7Fac-,Iity Hot Water Temperature Warewashing <br /> Name: Hand Sink: `F Chlorine: ppm Heat: `F <br /> Exp.Date: arewashing Sink: of Quat.Amm.: PPM I Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: Z16 3161" <br /> ..............- <br /> Time in: Time Out: Page of/ <br /> EHD 16.24 (2�pg) 4/3/13 V N FOOD PROGRAM OIR CONTINUAT17 <br />