Laserfiche WebLink
Y-1-09;A..lSAN JOAQUIN COUP <br /> `+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> W X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • c4., app• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sagov.org/ehd <br /> �IFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: e� J Date: :2- -r <br /> Address: 1 TrLe rn0 7.�- _L " City: C'/ Zip Code: q <br /> Owner/Operator: 4V <br /> .P-e Z Telephone: <br /> Program Element: 6/ Program Record: F Q� 6 5 J c/G Inspection Type: Q-j <br /> r � <br /> S131 80 PostedYes ! No Permit Posted Xyes F No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> gr,dl A— days <br /> Go v-2 r . ` • rzv v--►"a(X_ _ c ex Lam( <br /> tn 64 6 !Da /Vr /-1,- <br /> n GDA11" rO <br /> ,27 y T � ' v_ee D ccs ►� v� � r t a� crriy e r;L _ <br /> Item/Location Temperature Wern/Location Temperature <br /> Or <br /> G - -- - — - - <br /> "777717-- <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> —--- _..... ___..._ _..........................—_ .. __.. .._..__._ _._._..--- -- .—...— --- —_... - - ------- <br /> Name: D� ! / Hand Sink: 1 of Chlorine 5L) o Heat: of <br /> ppm <br /> Exp.Date: /_�(L_f-`-yv ar wa hing Sink: (!� of Quat.Amm.:: ppm Other: of <br /> Received By/Title: O <br /> EH Specialist: Phone: _ / <br /> Time in: n �a s� Time Out: w L Pagq�of <br /> EHD 16-24 (2nd pg) 4/3/13 `J FOOD PROGRAM OIR CONTINUATION <br />