Laserfiche WebLink
SAN .JOAQUIN COUP <br /> �-� ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: X <br /> - _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siQov.orq/ehd <br /> LrFoa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: , o ncA r i,vz, C ,V,eCA -� 6--' !�)G i Date: ) / 2�I <br /> Address: v �u r City: S�C��i-) Zip Code: G c 7 �' <br /> Owner/Operator. `N 6'1 f� U R o� i G Telephone: �1 <br /> Program Element: i kD Program Record: �,/��.9� Inspection Type: U . <br /> SB180 Posted Yes ) No Permit Posted Yes ��ccvv Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> ......................................-_...............-..... <br /> _._— _ _......_.._.................................__.._.__...._.._.. <br /> CM c--VkN <br /> e-c-t PiV� SSCI'f <br /> �- trcu cinaws rpm 0 — lcle cAt <br /> T � k cz, CCW .� A1oU *yrs-OV,e It -t <br /> i n u lam <br /> I <br /> -pkv iCAA �" <br /> Item/LocationTemperature Item/Location <br /> Food,Safety Certifiestion Facility Hot Water Temperature- -_ 1Nateashin <br /> g . <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: Ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: � Time Out: i O Pagel of <br /> EHD 16.24 (2nd pg) 4/3113 FOOD PROGRAM OR CONTINUATION <br />