Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • c.., `P. Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.siaov.oro/ehd <br /> 4ciFoaa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Lk L Date: I <br /> Address: �?� City: Zip Code: <br /> Owner/Operator: - Telephone r1 -11 -epic <br /> Program Element: Progra Record: Inspection Type:LG L_l tw <br /> §B1 80-Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> ✓l, l G /✓l G1`h <br /> Lw a u WAd <br /> fiWvtw <br /> a <br /> I.� vi�t v d r-nn OI V-12- <br /> V% <br /> t vxf <br /> �k- ri C ti DVS- <br /> . Item/Locatibn Temperature As - Item/Location Temperature <br /> F gcation .. Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: 'F Chlorine: ppm Heat: `F <br /> Exp.Date: arewashing Sink: "F Ouat.Amm.: ppm Other: "F <br /> Received By/Title: <br /> EH Specialist: f IPhone: <br /> Time in: Vl� � Time Out: CW Page o <br /> EHD 16-24 (2n°pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />