Laserfiche WebLink
c 11 <br />■s <br />(COSJclG1 <br />tsc <br />J <br />\<^x CA aX <br />Temperature Temperature <br /><? <br />Food Safety Certification <br />\ <br />T <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />: — <br />San Joaquin Couni y <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 />Name: <br />Exp. Date: <br />Ware\ <br />PPm <br />ppm <br />Heat: <br />Other: <br />LXLF <br />\ i- <br />°F <br />°F <br />; U <br />O( \ X— <br />Phofie: <br />Time Out: <br />PvaAcC ~ 0(2, <br />->rA_\eY/ <br />I <br />F <br />HOF IF <br />X'oV.Z/ILT1S <br />Yes No <br />Page^ of <br />FOOD PROGRAM 0IR CONTINUATION <br />AA(?vJ <br />ci as/ <br />No ' <br />G\-^— <br />Item/Location <br />I'fi <br />___2<&fFF lg) 7 <br />Facility Hot Water Temperature <br />Hand Sink: op Chlorine: <br />Warewashing Sink: op Quat. Amm.: <br />Item I Location <br />/A-V^-rx <br />v • —i <br />Program Record: <br />Permit Posted Yes <br />c'ty: NWA^-x <br />_____________ Food Program Official Inspection Report <br />Name of Facility: (\A c Date: <br />ftddress: ;---x'Av< ' City: ZipCode: ASSSb <br />Owner/Operaior: gx— A-\<X-<,.1^ Telephone: HOS-2Q7q <br />Program Element:^., / | Program Record: ■Smo^^_____________Inspection Type: : 7 <br />SB180 Posted Yes No Permit Posted Yes No ' Re-Inspection on or After: <br />S-K/o 100 <br />G) A>peeA^ <br />LUo W-F <br />gpAob SO <br />IZbF / fcAj) <br />Z P-0 Q sFtaSlQ qt>caaz\ xn <br />H 7^23 O,-Q-yy-x^, Fo F ! <br />GoQn Gcan / <br />Fr ' % [To f z <br />Received By / Title: <br />EH Specialist: <br />Time in: S O C\ <br />EHD 16-24 (Z^pg) 4/3/13 '