Laserfiche WebLink
°"�" SAN JOAQUIN COUNTY <br /> �o ..........� <br /> ®E`-g ••OG <br /> N: X <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.s*gov.org/ehd <br /> ��F+O Rta <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: )L'1,11 <br /> Address: 10 100City: kc Zip Code: r-� 3D <br /> Owner/Operator: `er one; Dcc`7��''©y Q <br /> Program Element: # Orogram cord: Inspection Type: 1 <br /> SB180 Posted n Yes No Permit Posted 7i Yes E No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> C. <br /> 0 <br /> D � � <br /> r a s� l icw Q C�� �ai.� � z8 vccLeO. <br /> Item/Location Temperature Item!Ltio: ;Temperature Item/Location Temperature <br /> oca <br /> Food Safety CertifN 'on Facility Hot Water Temperature Warewashing <br /> Name: CXHand Sink: of Chlorine: ppm Heat: of <br /> CArt <br /> Exp. Date: �0 Sarewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: /1 <br /> EH Specialist: Phone:, o <br /> Time in: C Time Out: Page/ of / <br /> EHD 16-24 (21°pg) 11009 FOOD PROGRAM OIR CONTINUATION <br />