Laserfiche WebLink
,oP4 .•C0o SAN JOAQUIN COUt <br /> y� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.slpov.orp/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: �3 <br /> Address: City: Zip Code: <br /> Owner/Operator: elephone:#77...i <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes _ No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 1 <br /> if.Ll <br /> of OF 09 <br /> Item/Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: `F Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat. Am m.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: lam. Phone: AS—D-63 Lf <br /> Time in: I 1 Time Out: Page of <br /> EHD 16-24 (2nd pg) 4/3/13 I FOOD PROGRAM OR CONTINUATION <br />