Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> w W: 600 E. Main Street, Stockton, CA 95202-3029 <br /> •� <br /> Telephone: 209 468-3420 Fax: 209 464-0138 Web: www.s ov.or lehd <br /> A t � ( ) 19 9 <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: A� Date/r `r m e <br /> Address: r, _ p� City: y Zip Code: S73,A/� <br /> Owner/Operator: Nn R 914 1 T �,l�!; JH Telephone:Cry%r,2Yq814�) <br /> Program Element Code: Program Record ID: Inspection Type: <br /> si�v�sr� <br /> iSB1 80 Posted ❑Yes ❑ No Permit Pasted ❑Yes 0 No Reinspection On or After: <br /> Y .. . ..T - � C? rt.. i `. D CO_ .: GT1 _. to .N$ :. 4 . <br /> IN <br /> �>� _ 2�r� <br /> 15 77R,Lt ! f►aS 5�Criu c� �� . <br /> i <br /> T7'�iC fZu� O W A.1C U,:�-1,1!4 d4LC <br /> A ND Umar <br /> A. <br /> I <br /> I <br /> TT <br /> irn _nca b► Te a :Locatlg ;T .. Ilrt>!1 ori, "Tetnp+ ,.: <br /> •:`F. "F�dac' if C�rt4` tlaA ".. .... .� .. CLlity�HotlMefeSIIp6rdtU;.E...., ->�. u, :.»?.W s:-..w1iKL,wa'4[7ram-en#�t�'s:? <br /> Name: Hand Sink: 7 Chlorine: ppm Heat• °F <br /> Exp.Date: arewashing Sink: °F Quat.Amm. ppm Other: ppm <br /> ENVIRONMENTAL HEALTH AND SERVICE CHARGE FEES ARE AUTHORIZED BY RESOLUTION OF THE SAN JOAQUIN COUNTY BOARD OF SUPERVISORS. <br /> ALL.DOCUMENTED CRITICAL.HEALTH VIOLATIONS OR REPEAT VIOLATIONS ARE SUBJECT TO A REINSPECTION AND REINSPECTION FEE. <br /> Received By: ,y y� ` 1 y� Title: <br /> EH Speciali t: K t1 a Phone: f 3 <br /> Time In: I Time Out: `7 y Page; of <br /> S 6 s <br /> EHD 16-23(2ND PG) FOOD PROGRAM OIR <br />