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ora"'M. F SAN JOAQUIN CCOUN vv <br /> ' ENVIRONMENTAL HEALTH DEPARTMENT <br /> A <br /> _ - 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.sogov.ora/ehd <br /> '4CjFO'nia <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: - TQ t r_ Date: <br /> Address: {� l r Q I c �a^ #ACity: S Zip Code: q S 2-G4 <br /> Owner/Operator: 1 h y Telephone: <br /> Program Element: Program Record: Inspection Type: ou4 t't <br /> B180 Posted Z Yes No Permit Posted E Yes No Re-Inspection on or After: <br /> 0",EA'VAM. .N C0RRECT4VE ACT NS <br /> C a Is b e to j POo dl a Co f r e c v -1' <br /> �c A3 : 15 Ief n ha ,. d Qnd _ �. s-. ,iV. <br /> �Cr's' 15 G n d )4 e" s n l<5 G leu r Q i, dens,"IS Cc rre, C i _ <br /> A <br /> 3 <br /> ��'2IN 5 001 h i f04 r or M <br /> p � atrA J hr lic4j lie a ' <br /> Fcap/- IY ; 4 fnt; n "1.7e f' redri r 41,c�� <br /> 1 G be v e 0 rrp 4 CA a n W. >♦ h <br /> G , n tO G .5r-A 0 rJP ! r� <br /> � — Wa 0P5, // <br /> 0 T, lb nG Ve b(A - &•ua . C PG /� 10ela <br /> I we er, �c 0 - .1 a j�l P G n d S �!'� r✓1 acs b/� - - <br /> r G C 1PAnCrh le Ira lc ar, vn Corroc1PPc <br /> 5 S 4O► r - ;n 7tn r bo -q; �', r,* f r a rrc• 1L r. <br /> b e to. rntne , foc ds . or -i <br /> P r c a, 0_ SCroon dor <br /> re vi, n5e i S.5 F -lo <br /> S 1, LO r- hl ar: r+r <br /> I <br /> tenit aGaitrne,. .... .u ftett.t. «� tta, Tetlp'rlr item 1 ttion Tem reture <br /> 'FVer � C, le <br /> SIG br )~ <br /> Food safe Mt €r+ 8 3i. o3 Wit dem „a cre N(wewa ng <br /> _. _. <br /> Name: Hand Sink: /4c,.� aFChlorine: ppm Heat: 'F <br /> Exp.Date: arewashing Sink: o of uat.Amm.: ppm ther: of <br /> Received By/Title: <br /> EH Specialist: Phone: T <br /> Z L �,�/ <br /> (J <br /> Time in: r1 G(} Time Out: " Page of j. <br /> EHD 1624 (2-pg) 419112 FOOD PROGRAM OIR CONTINUATION <br />