Laserfiche WebLink
( <br />C <br />o <br />( <br />a r^> <br />Chlorine:•FName:ppm <br />Other:Quat. Amm.:Warewashing Sink:°FExp. Date:’F ppm <br />to <br />Phone: <br />EHD 16-24 (2* pg) 40/13 <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.org/ehd <br />Warewashing <br />Heat: <br />t-recrz^e <br />USE- C <br />Item/Location <br />? IQO- <br />____________Temperature __ <br />P------ <br />Food Safety Certifli <br />Temperature <br />____2=^^_____ <br />TimeOut: Pag&pof <br />FOOD PROGRAM 01R CONTINUATION <br />Received By/Title: <br />EH Speelall^-^ tzgLa^e <br />Time in: <br />item / Location <br />Name ot Facility: (\AA^C V~AA «er I <br />Address: o » r— x A ~ <r A <br />Owner/Operator: <br />Program Element: r_CLO / I Pr09ram Recortl: <br />SB180 Posted Yes No Permit Posted <br />MM <br />Food Program Official Inspection Report <br />Date: <br />Clly: IWVx fld<A^S.2'PCOlle: <br />Telephone: <br />inspection Type^^^^ / <br />Re-Inspection on or After: <br />____ _____________________I <br />Facility Hot VVater Temperature * <br />Hand Sink: op <br />—. 3 OBSERVATIONS AND CORRECTIVE.ACTIONS <br />\o <br />ZetAo \jc\W@ <br />ywx <br />V qo^2 <br />Yes No f <br />l»