Laserfiche WebLink
o.P�"`''• o SAN JOAQUIN COUP <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> `4il�dw�p Telephone:(209)468-3420 Fax:(209) 464-0138 Web:www.sioov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: S• Z S <br /> Address: c City: S Zip Code: ? S Z <br /> Owner/Operator: J I Telephone: 13 -7Y <br /> Program Element: )F7/ 12 3 Program Record: S R 06 7.2 ,p S= Inspection Type: 1, <br /> 8180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> V ; n.4� Unable h <br /> 1 rc) v;de Owner horse CA <br /> h S '. (CA ;111, 1912 S;�fkeg!r <br /> s vr c pncl J • 6 • Rm S . <br /> froj.' d( wottIfj cc; i I Wf <br /> 0011• ner S4-ar V 744ed in 6hoijo COU <br /> _ Item/Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: , L13 -F Chlorine: ppm Heat: 'F <br /> Exp.Date: arewashing Sink: "F Ouat.Amm.: ppm ther: 'F <br /> Received By/Title: T / <br /> EH Specialist: Phone: D/ fi,f/A <br /> Time in: ( Time Out: p I.2Page( of <br /> EHD 1624 (2,dpg) 41Y13 (J / FOOD PROGRAM OIR fAUTINUAT10N <br />