Laserfiche WebLink
SAN JOAQUIN COUN1 Y <br /> ?a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �q.. -'.�;;P• Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.s*gov.org/ehd <br /> �/FpR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: l7ieJ 4o Go C Date: /0 - <br /> Address: \ City: GrtZCk.,( Zip Code: 15 Z <br /> w <br /> Owner/Operator: A A a Q Telephone: <br /> Program Element: 1 Program Record: v ! O 2 Inspection Type: ,c ' <br /> SB180 Posted Yes Ll No Permit Posted ❑Yes [I No Re-Inspection on or After: t]Q ^ <br /> OBSERVATIONS AN©CORRECTIVE ACT IO14 1 P re N <br /> o L - ., , <br /> a �ftc,-e_ /= mr bpt izo d cise <br /> 2 ) ?—Ln i rt_c r -S ,— ; e., <br /> r14 Ir k' a V.-I Gl ea n. <br /> vyw <br /> 4al I '�. 54-0 o k 4- <br /> �rCX L 11�a.✓r alp 1,e e o 4-cA 1 rvr <br /> �- C, ✓i S ex r-e• �ned f4%x— � �► <br /> Name: Hand Sink: 'F Chlorine: ppm Heat: 'F <br /> Exp.Date: Warewashing Sink: -F Quat.Amm.: ppm Other: 'F <br /> Received By/Title: <br /> EH Specialist: Phone: L' G%_A Y V<-- <br /> Time in: , v Time Out: 1 Page/of <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />