Laserfiche WebLink
Metadata
Document management portal powered by Laserfiche WebLink 9 © 1998-2015 Laserfiche. All rights reserved.
�o�4 .coG SAN JOAQUIN COUNO <br /> y-+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • cq.. '�;p• Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.si4ov.orp/ehd <br /> L�FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 0W 11A, <br /> Date: f ZAe' ,- fJ <br /> Address: ' �b City: 54 011r" Zip Code: c1�06 <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: ft�o�.� Inspection Type:IS <br /> 8180 Posted Yes Permit Posted No Re-Inspection on or After: w <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 561 $0 v � sf+i✓. �I f�(1 I e&k fv <br /> L '4- *W 'w hl Nx, <br /> Item/Location Temperature Item 1 Location _ Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> — ------------- ------ <br /> Name: Hand Sink: of Chlorine: Ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Ouat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: ��— Phone: <br /> Time in: lug,ryt Time Out: ,1: Page of <br /> EHD 16-24 (2ndpg) 4/3/1'31 FOOD PROGRAM OIR CONTINUATION <br />