Laserfiche WebLink
apes!'" SAN JOAQUIN COUN r <br /> g ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> c*Plaen�;� Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.siclov.orq/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: h. l acei Date: <br /> Address: 6 7 g A) Is,, W 5 g,/U City: U Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: InspectionType: <br /> U <br /> SBISO Posted ❑Yes ❑ No Permit Posted ❑Yes ONO Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> U) I\S c, n ' ar j Cream 5C 0 Wef! <br /> h W 0 4 y r � n Wa -(e r <br /> Q PS i C e cc as nes d <br /> rre c 1-r <br /> a le I ok r- G /C <br /> G <br /> 3r, In n C <br /> q4 Gr el v, <br /> a d S r )' l l <br /> K ass a N s <br /> 6e r Mn I <br /> Ci <br /> Oki <br /> 1 / c ( C F I I` l: <br /> Gere L Yad <br /> f ✓; 61CA ¢ <br /> ar w <br /> ItemlLocation Temperature Item I Location Temperature Item I Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: 1/a ,F hlorine: PPM eat: .F <br /> Exp.Date: arewashing Sink: 1/ "F Quat.Amm.: PPM ther: OF <br /> Received By I Title: <br /> EH Specialist: hone: <br /> Time In: /,; c, Y Time Out: Page of <br /> EHD 1624 )2°pg) IUM FOOD PROGRAM OIR CONTINUATION <br />