Laserfiche WebLink
SAN JOAQUIN COUi, . t <br /> . 'gip_ ........e <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazefton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax. (209)464-0138 Web:www.slgov.orglehd <br /> Z�i=oRa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: i Oh �� �� r Date: 7 r�OZZ <br /> Address: Alt �"j4tt �G City: Zip Code: <br /> Owner/Operator: .J i V /_ �(" <br /> (J'` Telephone: <br /> Program Element: 5 Program Record: � + Inspection Type• ze�A'` <br /> 5B18D Pasted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Y rcoc� <br /> R' JL44 ri r ' 0 k- u �o <br /> GC <br /> v► 004[otn„ <br /> - V11 _ <br /> ltern/Locatlon Temperature 11 Item/Location Terrlperature <br /> i <br /> Food Safety Certification Fap�iEty Hot`N2t c.T�mperatttre Warewashrnq . <br /> - _ <br /> Name: Hand Sink: F Chlorine: pp- ,Heat. F <br /> Exp. Date: Warewashing Sink: F lQuat.Amm.: ppm Other: F <br /> Received By/Title: <br /> _ 1 — <br /> EH Specialist: Vat It Phone: <br /> Time in: T Time Out: I Page l of <br /> EHD 16-24 (211°pg) 413.13 FOOD PROGRAM OIR CONTINUATION <br />