Laserfiche WebLink
Op.°"'" SAN JOAQUIN COON <br /> ........ C <br /> y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.siaov.orq/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: S �� h, Date: <br /> ddress: 22 7 City: Zip Code: <br /> c <br /> Owner/Operator: r� �� 2Telephone: 396( 0(0 <br /> Program Element: 1 1 A 1 Program Record: b� A Inspection Type: I V <br /> 8180 Posted SCJ ❑Yes ❑ Rermit Posted ❑Yes ❑1 Re-Inspection on or After: p� <br /> R <br /> C \ � S <br /> v.rt cQ 2 <br /> � � 2 <br /> L _ <br /> If <br /> s -� DL <br /> .N 2- <br /> m yrnpera ure: <br /> ;c r a .; <br /> t <br /> Name: Hand Sink: of Chlorine: ppm Heat: aF <br /> Exp.Date: arewashing Sink: of uat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: `-'1 - 1 r Phone: _ O� <br /> Time in: `11 2 S Time Out: n � � Page�of � <br /> EHD 16-24 (2n°pg) 4,'3/1133 C• FOOD PROGRAM OIR CONTINUATION <br />