Laserfiche WebLink
SAN JOAQUIN COU Y /O1` da j <br /> .Z� ENVIRONMENTAL HEALTH DEPARTMENT 75.2-8C{2 / <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> ��FORt� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 'S D�jn G1!�S Date: �� I ,1 <br /> Address: /q r O rQ a City: `�C-)6- Zip Code: pJ,S 2oZ <br /> Owner/Operator: / N � G, Telephone: 3 V-6 W5 <br /> Program Element-.tG d / 5�3 Program Record: '5 2 0 0 "2I �O y Inspection Type: _ /ting/ <br /> 8180 Posted ❑Yes ❑ Permit Posted ❑Yes ❑I Re-Inspection on or After: T� <br /> A � - <br /> r., <br /> Yl n-" d- Yl V" a,6 so r n' <br /> n -% UU of r -4 Y c s ooc, r31 <br /> W$ K_6tU `13 4 C30 T LA <br /> .�vi-s4-z I;1 t n 5 ►--,A h 1.Pr <br /> � P S►tits <br /> ► dS T2 La1 Yd <br /> ti s•i �, 1�,�l�t�e v-� � cd, a <br /> ►� oA n <br /> S'I r rq-,5 C-) m-s . <br /> WIPIRMNIP <br /> Name: Hand Sink: of hlorme: ppm Heat: of <br /> Exp. Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist:-10Phone: 3 '7"�7 <br /> Time in: Time Out: ,�+ �5 Page of <br /> i `1 <br /> EHD 16-24 (2o°pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />