Laserfiche WebLink
SAN JOAQUIN COW'dy <br /> ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> .., P Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> 9�%FOR? <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: -- Date: <br /> Address: rrt.�-It + City: -fo Ge+t�n Zip Code: <br /> Owner/Operator: Telephone: qI64-235D <br /> Program <br /> 64-23S- <br /> Program Element: ' -ZLA V Program Record: C4Inspection Type: YL� <br /> S13180 Posted +Yes No Permit Posted *yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> to f ` Ca'--k r--p- `cJ VL 0.Ll <br /> O A a to p 4- bL4 I-q-17 <br /> CKV F+D c.D m <br /> u <br /> n 4a.0 <br /> n <br /> 15 a-ej-1 <br /> Item/Location TTemperature Item l Location Temperature <br /> Cl0 3_ <br /> 1z (in <br /> mza�+ I a <br /> ame: 1_. m and Sink: 1 g -f rin :• � Ppm eat: =F <br /> Exp.Date: 1'1 3 -SI <br /> -IL b arewashing Sink: /r of 11 Oust.Amm.: ppm ther: =F <br /> Received By/Title: �/O <br /> H Specialist: . Phone: <br /> Time in: -4-6 Time Out: �,ry� Page ofd <br /> EHD 1624 (2-pg( 4/3-113) CJ--� F000 PROGRAM OIR CONTINUATION <br />