Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> Q` ENVIRONMENTAL HEALTH DEPARTMENT <br /> e: .< <br /> _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.s'gov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: ,G,-1 City: Zip Code: q5 <br /> OwnerlOpemtor: _ a �/ Tel hon , Z Z <br /> Program Element: P ro ram Record. - .Z;�I_ Inspection Type: <br /> B180 Posted Yes YJTO) Permit Posted a No lJ Re-Inspection on or After: <br /> ' OBSERVATIONS AND CORRECTIVE ACTION..$• <br /> u <br /> N�j AV <br /> 4 is <br /> Ud o <br /> K& " <br /> �d Q �z <br /> .. _. - <br /> ItemlGocati <br /> non - Temperature r . Jtem/Location. - -` "yTo erature: <br /> -.- .— FdodSafety.Certification• Facility Hot Water Temperature• ` Vllarewa5tiing: <br /> Name: Hand Sink: OF Chlorine: PPM Heat: OF <br /> Exp.Date: arewashing Sink: OF Quat.Amm.: PPM Other: OF <br /> Received By/Title: <br /> EH Specialist: d J Phone:7'C"- <br /> ime in: Time Out: 0 Page of <br /> EHD 16-24 (2^d pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />