Laserfiche WebLink
SAN JOAQUIN COUV <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s44ov.org/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT % <br /> Name of Facility: '4 f Gn i Date: .2 <br /> 6-11 <br /> Address: 10 qQ , `, Ke+/e Q� '— <br /> L0 City: .) –r `C!1 ( Zip Code: �S. -10 <br /> Owner/Operator: (`e 11 I Telephone: 33L(r g j <br /> Program Element: Z Program Record: to � / �S � Inspection Type: O <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> l e r,01 _ ve fey. <br /> 2 C c�h •-� .-c �c71- e d C-c.�¢ l <br /> C"" <br /> s�•1 ..� Q Iv s s � �cir -2 4 c <br /> Item/Location Temperature Item/Location" Temperature <br /> L _ <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: L((o19 <br /> Time in: I y� Time Out: Z '_(Z3 c�j Page/of/ <br /> EHD 16-24 (2n^pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />