Laserfiche WebLink
SAN JOAQUIN COU f <br /> 2. ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> cq.. iP Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s*gov.org/ehd <br /> ��FORtN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: L TrL.E, L1-a lr A Date: <br /> Address: Z 2 2 rA ri n 0. City: C+O Zip Code: 5 r7 <br /> 2O <br /> Owner/Operator: I Y. TO hA n n c� Telephone: 15`7_19 1 ' <br /> Program Element: 1 to 2q Program Record: PRD I to D Ley 7 Inspection Type: TZDU-H <br /> SB180 PostedY.1Yes No Permit Posted Yes No Re-Inspection on or After: <br /> T"y&y - wood <br /> r <br /> C.e r C s n e.-[-�a�tQ..Q v-m o»..�t1e r <br /> ac-cX- W <br /> i �•K- i�-t l �L /J4 Lr 6k-e I v-e s <br /> 00.41 yloot &L S 0 <br /> aA4.ti FA+1 UA r ay-e- W-2-e.lC <br /> U.)1 Y 2—CO 5't Ae Y-e i <br /> ✓L a i- G't.i -t4- <br /> CV <br /> CV . <br /> rZ,6 NI-Pu-P -��LDnZ� a-CACS cal r- Pro Lti"at- 6�j rn epy,4-,� <br /> V1 O-TU.' A4 t, o C.Lka rl (..44e'r 1-0 r -e 4e-r 1 o r U wk.-' eW 0,:->cd - <br /> C,pl-bi-,A-f-5 �n Yom`4-r-kt.-i Cf Y-,-P� <br /> Item/Location Temperature Item/Location Temperature <br /> 35 F <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> ---- ---- - --_... _..... ..... ...__. _ _ .. ._.....:_.. _._.. .._.. = <br /> Name:^ r r p h � � Hand Sink: f C' r of Chl rine. (aAx�, ppm fit. ,4� f/o d°F <br /> Exp.Date: i _ arewashing Sink: q-� o f Ouat.Amm.: ppm Other: o f <br /> Received By/Title: ! <br /> EH Specialist: 1 Phone: <br /> � �3_ 1 <br /> Time in: O; WIi7 Time Out: I Page Z <br /> EHD 16-24 (2^d pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />