Laserfiche WebLink
<o: fl <br />City:Zip Code: <br />k <C \C <br />Telephone: <br />Inspection Type:Program Record: <br />Re-Inspection on or After:Permit Posted <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />v' -\\ \ r <br />v3 (2 j <br />To <br />Va-Q-J^-vAA..')I GA. <br />1111; J <br />Item / Location <br />) <br />Chlorine:Name:FPPm <br />Other:Quat. Amm.:Warewashing Sink:Exp. Date:°F PPm <br />Phone:moR- oSK <br />Time Out:Time in: <br />Warewashing <br />Heat: <br />_ izJ -C -s, <br />\ <70 C \ ~ <br />i mR <br />XJ_________ <br />Item/Location <br />G 8 ) W ( <br />Temperature <br />HoSF: <br />\'ll F <br />1 <br />I <br />Temperature <br />isIf <br />Goor <br />Pagq^)f <br />FOOD PROGRAM OIR CONTINUATION <br />°F <br />Yes No <br />Food Program Official Inspection Report_______ <br />Dale: R-iM-lb <br />«2> _______ <br />—— " ' --------- <br />G .Vw <br />Food Safety Certification <br />fT) T/xJx - -Up I <br />Ml <br />Facility Hot Water Temperature <br />Hand Sink: op Chlorine: <br />1 kjO <br />San Joaquin Cou. < <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 />t Am H 2 <br />T-GjQ s _________ <br />C A - CO-S - Vo <br />{Ay/ \\ \ F~ <br />Received By / A AaQ A aA <br />EHSpecialis,: A ■. <br />EHD 16-24 (2-pg) 4/3/13 <br />Name of Facility: ‘ <br />Address: <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes No <br />\c\^ - Oi <br />3 C<5\v^ (25 <br />5^ \a_t-Qq LV C> " <br />I kJ'Q t '___ ~2 <br />- K/O - (? - S -