Laserfiche WebLink
°"!" SAN JOAQUIN COU1\ <br /> z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <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: LcA I va r Ft A U G (=vow( (3ci✓t Date: It- 3 O _ t <br /> Address: sic-Ko'7 Ke(f e r City: S o c '�- 4 c c� Zip Code: cl Sze�j <br /> Owner/Operator: Telephone: <br /> f AU C.0 FU V d. G rt �-- 't-7-34 <br /> Program Element: ll03 L Program Record: U 5-157-7 S3 Inspection Type: <br /> SB180 Posted Yes ❑ No Permit Posted _. es ❑ No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> CLQ TGve re t u I < <c - ti I c,l <br /> Frec Z-erS 4,,.d dei a k+ - <br /> '2 1�10 t�crw.or►.e�erS rcy✓t�e�► !r 1 � fC�r� �zir or c,� -�'re zer <br /> Prov <br /> Fr Scc <t-5 �1 Fi r !t1 �t H 4C L r Prov <br /> CiLl - (,o7 - 3G4 <br /> Item/Location Temperature Item!Location Temperature Item/Location Temperature <br /> Kel=rtser•a�-0V- 3 6 F kJ<L ,A Rc4l rt <br /> 6�t\'rook"�_ ► 2-00 F — <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: of Quat.Amm.: PPM Other: of <br /> Received By/Title: S. <br /> EH Specialist: NU <br /> Phone: Lj _ 1�c.4 j <br /> Time in: I 15, <br /> S Time Out: t Z,c r Page ZofZ <br /> EHD 16-24 (2od pg) 11/2/09 FOOD PROGRAM OIR CONTINUATION <br />