Laserfiche WebLink
SAN JOAQUIN COUP <br /> � •.oG <br /> y ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ = 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> ��FO¢ <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: V(�l 1 1 ls� �� , --� Date: (12 <br /> Address: 1��_�' '� City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> 6180 Posted ❑Yes ❑ Permit Posted ❑Yes ❑ 1 Re-Inspection on or After: T� <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> y�p �� -c�'S C�'ne � x Ge�fi• <br /> i �+veui- vv, R ON- zI --4p-M h w in <br /> Thk c0610� nim OR 6LIOIR0 <br /> Eo6 i t1 , S p1 U ce ca i Ccc>W_R <br /> I 1 i cm -�m.Qrn i S C GNE r-eG) . <br /> Ull <br /> afi Gill -F1m--� <br /> 3 SOV (A-I I t--e --1-�- "t i>1 Oe- <br /> we -�i1 c we r 1 1 c1 <br /> !;A v aec p -mid <br /> U <br /> CAIN k10 S G w �) n s(3N fiU 11te ver A- ©-� <br /> Ih.e *X__)Cj cw d - Vii- Ord <br /> C -� �WoS �ze - Clown )-Odaq Oro VW& <br /> �C p s4� To (A CAJ \ < <br /> C r i 1 Z -Vi?�� <br /> itemLocp;,R a ��3 emperature Item t LocationTemperature' <br /> :; d 5afetr _,.. Ciiity Hot Water Temperature Warewashing - <br /> ev. <br /> Name: 1 1 I Hand Sink: of Chlorine: ppm Heat - -� _ F <br /> Exp.Date: ) I arewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: 1, U0 Time Out: O L) rJ �I Page' of II <br /> EHD 16-24 (2ntl pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />