Laserfiche WebLink
ot,44?'ry SAN JOAQUIN COUNTY <br /> .-.o <br /> i ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c& .. a ;p Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> ��t+=iiaa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 4 Date: S— 1 Z Z <br /> Address: ? , City: Zip Code: <br /> OwnerlOperator: Gt{j Telephone: <br /> Program Element: Program Record: v — Inspection Type: <br /> IS 8180 Posted Yes No Permit Pasted Yes No Re-inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS - W. <br /> . <br /> o --� DJr <br /> vtD <br /> Z ty I Se <br /> c <br /> F <br /> LA - <br /> ✓1 <br /> r <br /> — . L Lo C-j -- <br /> Item/Location Temperature Item I Location " Temperature <br /> I <br /> Food Safety Certification` Facility Hot Water Temperature_ Warewashing <br /> Name: v Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of uat.Amm.: ppm Other: of <br /> Received By I Title: _ <br /> 7 <br /> EH Specialist. q , Phone: 47/ Z <br /> lme in: Time Out: [ Page of <br /> EHD 1fi-24 (2"pgl 4013 FOOD PROGRAM 01R CONTINUATION <br />