Laserfiche WebLink
-' SAN JOAQUIN COUNY <br /> ENVIRIMENTAL HEALTH DEP TMENT <br /> 600 E. Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web: www.sjgov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: r r Date: <br /> Address: 33 City: f Zip Code: 2 <br /> Owner/Operator. to one" <br /> Program Element Code: / Program Record to: t / Insp 7 <br /> SB180 Posted r es O Nor(/ Permit Posted 'Yes ❑No1O Reinspection nor After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 0 <br /> f 19 <br /> i <br /> i <br /> Item/Location Tem . Item I Location Temp. ':Item/Location Temp. <br /> Food Safety Certification Facility Hot Water Temperature Warewashing 11 <br /> Name: Hand Sink: 'F Chlorine: ppm Heat: -F <br /> Exp.Date: arewashing Sink: 'F Quat.Amm. ppm Other: ppm <br /> ENVIRONMENTAL HEALTH AND SERVICE CHARGE FEES ARE AUTHORIZED BY RESOLUTION OF THE SAN JOAQUIN COUNTY BOARD OF SUPERVISORS. <br /> ALL DOCUMENTED CRRICAL HEALTH VIOLATIONS OR REPEAT VIOLATIONS ARE SUBJECT TO A REINSPECTION AND REINSPECTION FEE. <br /> Received By: Title: —� <br /> EH Specialist: Phone:q f fJ / Q—O 3 3 <br /> Time In: TiOut: 6-(J <br /> 11,'A5 ��, me Page: 2 of <br /> EHO 16-23(2ND PGI FOOD PROGRAM OIR <br />