Laserfiche WebLink
r <br /> � SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> _. q a`P.. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.orglehd_ <br /> �fFOA <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Date: - I <br /> [Program <br /> ame of Facility: � � a M � S L I1 G G J " <br /> ddress: 5 Cr S } S �� city: Lq Zip Code: 175,3 jv <br /> 0 �c <br /> wnerlOperator: tJ !1 Telephone: <br /> Element: U I Program Record: S c c g 3 9 1 2 Inspection Type: <br /> 7 'n 1 <br /> B180 Posted 0 Yes 0 Rermit Posted 0 Yes n i Re-Inspection on or After: <br /> " 'WEAMN <br /> s C, f A aU 1 Wd ce r reLe j <br /> r.p n �rl <br /> -)L� q--: rn r <br /> 3 r <br /> oj <br /> R •lArt CC , h?' T + }�_S il� l�or'►'1 �rf�� O�C.r <br /> Au Ust <br /> S.1. a lJ S,, •c% f G C� �.s (Anter- - <br /> - (A,St _ <br /> s-- o <br /> --.. -Gc1 a ,Occo�t�r� 4n S; 4c. <br /> iti : Tearr3lims <br /> Name: Hand Sink: F 106 Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: 1r�U of Quat.Am ppm Other: of <br /> Received By 1 Tit I <br /> EH Specialist: Phone: <br /> Time in: 5 Time Out: �- Page of <br /> EHD 16-24 (2�pg) 0!13 FOOD PROGRAM OIR CONTINUATION <br />