Laserfiche WebLink
°pug" SAN JOAQUIN COL 'Y <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> . . :p Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.sigov.orq/ehd <br /> 4CjFORe� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: O (_ Y Y>� City: 6i vcile--F� Zip Code: <br /> Owner/Operator: 'tom V4.545 Telephone: y 7 <br /> Program Element: I 1 Program Record: A a © q j Inspection Type: -� v <br /> SB180 Posted WlYes No Permit Posted Yes T' No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> F:Oo(3 han d 1'e r- La r(3--s are, ►moo <br /> 2 ,J Q <br /> -r� - �— o K- fa mGi n" -e-r <br /> Lj <br /> c_y >-►rl o r jD e r rrt i-k-4C_4 <br /> u c P ra �� coo b la a�� _ - <br /> r-� n !6 1 <br /> L . <br /> ----------- __ - _ _ _ _ _T�__---___ <br /> Item/Location emperatureF -T Item t Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Hand nd Sink: i ' Chlorine (Heat <br /> _�•LC��r �S'�i✓jL`?1'� �_ F PPm � F <br /> Exp.Date: -7 `1 _ r Warewashing Sink: \ Z� F Quat. Amm.: Ppm iOther. 'F <br /> Received By/Title: 1 1 <br /> - - - — <br /> EH Specialist: t_ - - - - -- - - .....- - <br /> Phone: <br /> Time in: Time Out: J O Page �f Z <br /> EHD 16-24 (21d pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />