Laserfiche WebLink
ojPWt4 <br /> C, SAN JOAOUIN COUP <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenge, Stockton, CA 95205-6232 <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: r Date: �• <br /> Address: Gc City: Zip Code: C` <br /> Owner/Operator: Telephone: J <br /> Program Element: Q Program Record: Q S Inspection Type: <br /> S8180 Posted Yes No Permit Posted Yes No Re-Inspection on or After- <br /> OBSE VATIONS AN CORRECTIVE ACTIONS <br /> '7� L-. <br /> 4094 <br /> V <br /> OF- <br /> Item/Location Temperature item f Location Temperature <br /> Food Safety Certification i Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: F Chlorine: ppm fHeat: F <br /> Exp. Date: Warewashing Sink: F iQuat. Amm.: ppmOther: F <br /> I <br /> Received By 1 Title y - <br /> EH Specialist: Phone: <br /> Time in: Time Out: Page of <br /> EHD 16.24 (2n°pg) 413113 FUUD PROGRAM OIH GONTINUATIUN <br />