Laserfiche WebLink
SAN JOAQUIN COUN <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siciov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: ,...(-foLei' ii(A, (.127,„yti c.),-yre - Date: icy/Ay/ / e <br />Address: c5-7eem-r Zip Code: / 7/ 7 ..r. 1-1,ir "c=p, , r, 4 = . City: <br />Owner/Operator: #...6 i <br />f-V*7p- <77? • I ( cl•-•*-41 /' Telephon <br />Program Element: / (o s 7 Program Record:rg57.s---,s-e2--. Inspection Type: <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />7 ...e_ ,Sc-40-0/7 ,S4el 41117 1-43/7 0-12- tc42_._ Che.S17 /41,70/7-ftWe <br />42— c.../...sertselle_ 120e.-C/7-e-elo-EV- -11=. c St-0-41r • (51,30-le_ /C-e-- <br />e-Cy•"7-ec,"-- Ar IS -a.%) 2- 4:26,.....s7 <br />1-4, ce--9 / zre---c'94-tio---- '-e-p 0^-/- CS kle=1"-- <br />111or7 C0--rig;4— A-2.-rec.44=-A--- /-2&rcze----1--- 0,7 ,ri-74e 4.01-- <br />ea/a <br />-/-1. 1-6.-- <br />Item/Location Temperature Item / Location Temperature <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink:/7 //5) t % Chlorine: PPm Heat: °F <br />Exp. Date: Warewashing Sink: o F Ouat. Amm.:PPm Other: °F <br />. <br />( (4 ./ --> <br />Received By / Title: -ir /MIA,/ <br />EH Specialist: Phone: /P-3 445,-....2.. <br />Time in: <br /> <br />Time Out: Page of <br />EHD 16-24 (2nd pg) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION