Laserfiche WebLink
P4"'" SAN JOAQUIN COUNTY <br /> �o. .goa <br /> Q` ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • ... ;P• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd <br /> a�;FaR� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: Telephone: <br /> 0,1 <br /> Program Element: —Pro-gram R ord: Inspection Type:Ike- <br /> 32 <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> 00�-- o • <br /> it2 le if- 10 <br /> Sop <br /> f <br /> l <br /> em/Locatiory eitiperature Item/Location Temperatu[ <br /> Food Safety Certification Facility Hot Water Temperature Warewashing__ <br /> --- - ' _ __ ----- - -N Chlorine:ame: Hand Sink: °F pPmHeat: F <br /> Exp.Date: Warewashing Sink: of uat.Amm.: ppm Other: of <br /> FH <br /> d By/Title: - <br /> cialist: -�- / Phone: i ?i <br /> �'130 <br /> Time Out: Page of <br /> FOOD PROGRAM OIR CONTINUATION <br /> EHD 16-24 (2otl pg) 4/3/13 <br />