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FOODGRAM OFFICIAL INSPECTION P4&RT <br />SAN JO QUIN COUNTY PUBLIC HEALTH S ICE <br />ENVIRONMENTAL HEALTH DIVISION <br />P.O. BOX 2009, STOCKTON, CA 95201 <br />DBAiNAME <br />DATE , _//,f <br />ADDRESS <br />RECHECK DATE <br />OWNERIOPERATOR <br />COMPUTER NUMBER <br />MAILING ADDRESS <br />TIME IN 1'� ,�^- <br />J <br />PROGRAM IELEMENT <br />SERVICE <br />TIME OUT <br />APPLICABLE LAW I, j� <br />PERMIT LICENSE <br />2/88 <br />The marked items represent Health Code violations and must be corrected as <br />MAJOR MINOR <br />follows. <br />Food Temp. <br />1, 2 <br />Z <br />Prep/Service <br />3= 4 <br />LO <br />Storage/Disp. <br />5„ 6 <br />_ <br />`� <br />7J 8' <br />LO <br />Frozen Food <br />1/ "/� 0 <br />0 <br />Pure Food <br />9` 10!( <br />a <br />Reused Food <br />11 4" 12' <br />Transportation <br />13: 14, <br />J <br />Handwashing <br />15 16 <br />iDisease <br />W <br />Trans. <br />17 18 <br />19' 20 <br />Employee Habits <br />Z <br />Rodents <br />21 22 <br />Cr <br />Insects <br />23 24 <br />> <br />Animal/Fowl <br />25: 26. <br />` <br />_ <br />Wash./Sant. <br />27 28 <br />za <br />Equip. Cond. <br />29 30 <br />UJ <br />0 <br />Uten. Cond. <br />r , <br />31 32 <br />ui <br />33 34' <br />, <br />Storage <br />Storage Fac. <br />35 36 <br />QRefrig. <br />Units <br />37 38 <br />66 o <br />Thermometer <br />39 ! 40' <br />W <br />Hazardous Mat. <br />41 42, <br />43; 44' <br />Spoils <br />w <br />Water <br />45 ! 46 <br />3 a <br />Cross Conn. <br />47 148 <br />W <br />Liquid Waste <br />49 50 <br />51 52' <br />Q <br />Refuse <br />Premises <br />53 i 54 <br />r <br />Lavatories <br />55 56' <br />w 0 <br />Toilets <br />57! 58 <br />Cr a: <br />Dressing Rooms <br />59, 60'' <br />Ventilation <br />61 62 <br />63 64 <br />W <br />Floors <br />M <br />Walls -Ceiling <br />65 66 <br />U <br />Q <br />Janitorial Fac. <br />67 68 <br />U-1 <br />Lighting <br />69 70 <br />Clothing -Linen <br />71 172 <br />U <br />73 74 <br />c_n <br />Living Quarters <br />Signs -Permits 175 <br />76 <br />ESTAB. STATUS: (MARK ONE) <br />77 78 79 80 81 <br />REC ED BY: <br />r <br />ED G[] A ❑ F ❑ P ❑ <br />OFFICE ADDRESS <br />445 N. SAN JOAQUIN ST., STOCKTON, CA <br />S <br />LEGAL ACTION: <br />82 83 84 <br />(NO MAIL IS RECEIVED AT THIS ADDRESS)7'Zzx_ <br />CITATION CLOSURE OTHER <br />PHONE (209) 468-3420 <br />PAGE F <br />2/88 <br />