Laserfiche WebLink
o.P4Sln• SAN JOAQUIN COUNTY <br />'' � •sAc <br />a ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />•.04., ;s • Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siaov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />'"-Y la�i//✓Date: <br />11312-3 <br />Address: / -^ <br />- 1 sem .e` <br />W <br />City: <br />/., Zip Code: <br />T 33 4 <br />Owner/Operator: <br />G <br />J <br />LL� <br />Telephone: <br />Program Element: <br />Program Record: <br />Inspection Type: <br />8180 Posted Yes <br />No Permit Posted Yes <br />No <br />Re -Inspection on or After: <br />(SERV1 <br />N§AUD.,QgRRECTI�VEACTIONS <br />e <br />� <br />� t <br />t <br />� <br />f <br />l <br />� <br />1 <br />s <br />r <br />� m/loeation <br />e <br />' Location <br />7Name: <br />tgod Safety Certification Facility Hot Water Temperature <br />Hand Sink: <br />Warewashing " <br />'F Chlorine: ppm Heat: "F <br />Exp. Date: <br />arewashing Sink: <br />�F <br />Oust. Amm.: ppm <br />Other: 'F <br />Received By / Titie: <br />r/pJ�A <br />G / <br />50/ <br />EH Specialist: <br />' �(��-- <br />Phone: Z 01-6' 16 <br />Time In: <br />Time Out: , Z Page of <br />EHD 16-24 (2n°pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />L <br />