Laserfiche WebLink
SAN JOAQUIN COU/.' 1-Y <br /> W. ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> .. a Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sogov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: f Telepho <br /> Program Element: f Program cord: Inspection Type: <br /> CIL <br /> B180 Posted ❑Yes ❑ N/o Permit Posted d Yes [] No. Re-Inspection on or After: ' <br /> t.. _ �:` BSEI t�!"N�CJJNS AND C4F R�C3 VE I�,p +lS <br /> ,a <br /> a7ti <br /> fee, raid <br /> UAaAt <br /> ttetnli-ocatrun: <br /> Temperature Jbert%'1'1`_oeation. Tem orators; Item iitT <br /> Boit Cel ttiifit.� on oildot,Water TQm tore Warewaslx3ng <br /> Name: " Hand Sink: °F Chlorine: ppm Heat: of <br /> Exp:Date: Wairewashing Sink: -F Quat.Amm.: ppm Other: of <br /> Received By/Title: r I <br /> EH Specialist: Phone �� I <br /> n <br /> Time in: V Time Out: �. Pag of <br /> III <br /> EHD 16-24 (2n°pg) 11120 FOOD PROGRAM OIR CONTINUATiON ! <br />