Laserfiche WebLink
ac�w SAN JOAQUIN COUNTY' <br /> z ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (,209)464-0138 Web:www.si-gov.org/ehd <br /> �aR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: � te_�_s Date: <br /> Address: U JA6 'T4-N04 V401i <br /> City: 5 � � Zip Code: <br /> Owner/Operator: `-Nc, <br /> ITelephone: <br /> Program Element: �C� � <br /> Program Record: I?G !�2(QG� Inspection Type: fd`e-- <br /> B180 Posted 0 Yes ❑ Rermit Posted ❑Yes U I Re-Inspection on or After: <br /> L a <br /> m eu T <br /> - 1,3100 0Gr wC�t k r 11 = �fv <br /> oSUh� -les (sCL5v Cie -tr do . <br /> W &wO ` CUP-W r-0 1h)2 G1 Y- i(` ecT, 'IF- CNj2_ OLS <br /> Re� <br /> 3 TN-e n <br /> t 'Fj c-tff Sank "ttte Ccm c sn�- CUR <br /> T : <br /> v td an oven 0 ` wCk <br /> G - 00 b G �n a S.wO <br /> OVVVGW S f n 11.0 V SSaAc i e C,h&_e � aA <br /> Gl i-v �?.G G l (crrlre Or aL &c)bv\ as <br /> e <br /> MU SInK �7{�� S 'n C c F <br /> c�ci --eme <br /> Vf K0 0k 16 7011 6AV in f r <br /> ............ <br /> [ <br /> �.."I.,�Wftw <br /> W4 <br /> ............I­­ .,0- 1�11"7,_ <br /> Name: Nand Sink: O0 of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: l of Quat.Amm.: 2�v ppm Other: of <br /> Received By I Title: <br /> EH Specialist: Phone: n [� <br /> Time in: Time Out: _ PageZof 2 <br /> C�' V <br /> EHD 16-24 (2nd pg) 413!13 FOOD PROGRAM CIR CONTINUATION <br />