Laserfiche WebLink
0, aSAN JOAQUIN COUK <br /> � .�g.COG <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.slgov.org/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: W Date: <br /> Address: '�2 c/�j r.1 ��� City: �ry Zip Code: CSS 1� <br /> Owner/Operator: 1� Telephone: <br /> Program Element: Program Record: Inspection Type: Aw 1 <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> in (A )0 C,r-> Walls 4r\ d floc.- s: ),eS, C/e o n <br /> 0 <br /> Gr% tri is w— P15 (dr; V1 11%r14 as <br /> Y A 0 n pigCe fi rA jr doe.' i 'M Lie e k' <br /> 3 s ' 4i / <br /> Con �uin fle C 40 <br /> ✓ Li C' n r 70 AO Pe We <br /> AS'. cl a u re i of <br /> lo� o en t a nChe44 n �10 <br /> CG rrlc 1 41 dp <br /> C ojke r j !q (L h ro v hcu 1. d14J -lobo <br /> U W'5 rips 4ry 'V1 � a C I�s (3o q S0g& r) r <br /> G d rP t I la G/�a <br /> ry 1R I lOS ! r\ r/ / a rl or. CorrPc f l <br /> r. c K e i C i, n. k 2 n'1 c✓P oi', <br /> ' F - <br /> - -189T <br /> r l <br /> Item/Location Temperature Item 1 Location Temperature <br /> — — -- ..__�—_.. - ---------.. —_....------ .. . . <br /> 4(1 <br /> 'F T<< C r,, en <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Lt. Hand Sink:S ,�j' of Chlorine: m Heat: of cj �hAG Pp �, <br /> Exp. Date: 6 \ , ` Warewashing Sink: of Quat.Amm..- 5 ppm Other: of <br /> Received By/Title: yvvkv\ Ar <br /> EH Specialist: Phone: <br /> Time in: 1 Time Out: 3. v) Page f2— <br /> EHD 16-24 (2°pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />