Laserfiche WebLink
<br />- < V\o^ x' x-~ <br /> <br /> <br />Ki <br />EHD 16-24 (2nd pg) 4/3'13 <br />Phone: <br />time Out: <br />,;Uk 12-4F <br />caxt^x-a^ \ y <br />°F <br />°F <br />I ^<7x^1 As <br />>( Cj?/x V^tkhyAVs_____ <br />- x'tgazA-c-v. EA0 V~ <br />to) <br />Xq c |AIA) <br />n-' 32r <br />^xy2<^ <br />Temperature <br />SSF w < <br />Name: <br />Exp. Date: <br />z z2Xrv* <br />c <br />Temperature <br />V^S~F <br />ifflb <br />^IqH- O83Q____________ <br />\O' AAz' AT Page| of <br />FOOD PROGRAM OIR CONTINUATION <br />VA ' <br />____O-SSc j__________ <br />Program Record: G. <br />Permit Posted Yes No <br />San Joaquin Cou. f <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 />-p \-S <br />.zx^ p \J gA V t~_________ <br />n V ", 2-c\x Px- Z>oS. \ V ~ c V-Q^-zj2_ 1 I <br />Warewashing <br />ppm f eat~ <br />ppm <br />Item / Location <br />a; VAfrOal. <br />~ H H <br />e <br />Chlorine: <br />Quat. Amm.: <br />KV_____________ <br />\ CH A) tTAP <br />S3K ha a-y <br />Facility Hot Water Temperature <br />Hand Sink: op <br />Warewashing Sink: op <br />Item/Location <br />r)\Q-__________ <br />A. ____ <br />'~7 < <br />VaC (Ax xXZr <br />OBSERVATIONS AND CORRECTIVE ACTIONSC~J C -\ a '■ _ _ <br />yVk-O ~ y?_cxtxvJ) V2J5r________ <br />-Gv~okA <br /> hAEDx <br />Received By / Title: — KK- * <br />HtSneclalls*: .V.- -'- . A-7 . <br />Time in: C> \ i x— <br />c HX) <br />-H/G Ln C HA) <br />Xi Czar^-r-^ <br />^Z, oyr-r^p VZA f <br />c A Q <br />rj <br /> Food Program Official Inspection Report <br />Name of Facility: \ \ \ 1 OSKc/\AxX\0V hT V C<A A T K Pate~ Cl ~ ~ _ <br /> ’Aa v zi7S□wner/Operator: ^^5 ^ CCSSe, e ep one. <br />Program Element: » Program Record: __Inspection TyPe:~Y^qVxp <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br />p\Q <2~ <br />A) aAAx C-QfA; <br />Food Safety Certification