Laserfiche WebLink
SAN JOAQUIN Cour <br /> y� ENVIRONMENTAL HEALTH DEPARTMENT <br /> Vi: X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �4... - •.�;;P Telephone: (209) 468-3420 Fax.(209)464-0138 Web:www.si ocZ v_or /q ehd <br /> LIFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: City: Zip Code: ��ao <br /> Owner/Operator: io"I Telephone: t3_[-^7 <br /> Program Element: // �s Program Re rd: `� g Inspection Type: �O <br /> iSB180 Posted Yes c YJNo Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS`. <br /> 1 <br /> _- V <br /> -.... <br /> . .... <br /> L <br /> on <br /> � it Location i Temperature item/Location ` j Temperature <br /> Food Safety Certification Facility Hot Water Temperature Waf ewashing <br /> Name: Hand Sink: °F Chlorine: ppR� Heat: `F <br /> Exp.Date: rewashing Sink:,,_- I I 7 -F Quat.Amm.: ppm Other: -F <br /> Received By/Title: - <br /> EH Specialist: Phone:, pti�7 <br /> Time in: Time Out: Paged of <br /> EHD 16-24 (2^ pg) 413/13 FOOD PROGRAM OIR CONTINUATION <br />