Laserfiche WebLink
4"'" SAN .10AQUIN COUNAY <br /> �O c�G <br /> ?� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sogov.org/ehd <br /> �iFouN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ur + J Date: —1-2— <br /> Address: <br /> ZAddress: '5 3,•7 ,- 1 Hn r n A` City: C �p n Zip Code: 5�O <br /> Owner/Operator: 4 kj„a _1 .,.r a I c� Telephone: q8 2-0 8 sq <br /> Program Element: O I !/,5,,grogram Record: 5 OO �4 � Inspection Type: r;Pia I <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: r <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> s n Wo rig - <br /> L v>_ — U <br /> Wo r ►L c 4a- !tel <br /> � <br /> b r -e 0- i : k I <br /> is � l; <br /> 7i. <br /> n r af cAr sin ra bcr <br /> bQ <br /> Item/Location Temperature Item/Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Ware shing Sin : /;Z3 o f Quat.Amm.: ppm Other: 'F <br /> Received By/Title: <br /> EH Specialist: G� Phone: 5 `- 2 <br /> Time in: Time Out: r r Paget of <br /> EHD 16-24 (2'd pg) 1/18/12 `t FOOD PROGRAM OIR CONTINUATION <br />