Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.si4ov.orq/ehd <br /> <<FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: E C c,\A- k Cs 1 E `) r ` Date: ?` — '9 <br /> Address: 2> City: Zip Code: <br /> Owner/Operator. �JC t "\\ A C14, <br /> Telephone: <br /> Program Element: ` O2 Program Record: Q 0_--s Inspection Type: �i r <br /> SB180 Posted Yes No Permit Posted Yes No > Re-Inspection on or After: U <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 2 pp cS—Q S�(1a� �' C 2 S <br /> c�2 <br /> fV <br /> b S t-v <br /> S 3o <br /> n ` <br /> 2C 3SS <br /> Item/Location Tempera#ure Temperature <br /> C'_ - ♦ W e �lhS`(�\ .3-k k cop <br /> 1 <br /> F od S fety ertification IFacility Hot Water Temperature 1Nar Masi3ng „ <br /> Name: IHand Sink: t 'F Chlorine: ppm Heat: F <br /> Exp. Date: I arewashing Sink: 1 'F Quat.Amm.: ppm IOther: 'F <br /> Received By/Title: \ <br /> El Specialist• Phone: <br /> Time in: 2 + Time Out: t 2 -�J Page of <br /> EHD 16-24 (2^a pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br /> 5 <br />