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o.RN4tIN. c SAN JOAQUIN COL,�'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.siaov.org/ehd <br /> crea'R <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> ame of Facility: C '— � Date: 1G—z— IS <br /> ddress: City: Zip Code: <br /> caner/Operator: �/ C1 _ Telephone: <br /> rogram El a t:i ,� Progre�Record: b 22 S� t02.3 Inspection Type: �J , <br /> 8180 Posted ❑Yes ❑ Rennit Posted ❑ es ❑1 Re-Inspection on or After: <br /> - C tit <br /> � 1 <br /> 02 <br /> of <br /> S } O! <br /> c �' 3S <br /> `T <br /> 1S = \ 1 <br /> _ � 1 <br /> 50 <br /> s 1 <br /> - 1 <br /> ;ame: and Sink .F hlorine: ppm eat: 'F <br /> arewashing Sink: 'F Quat.Amm.: ppm ther: •F <br /> Eeceived I Title:t: Pho. S-0 'M S•-3 Time Out: S, M PagLE e�f <br /> EHD 1624(T°pg) 413/13 FOOD PROGRAM OR CONTINUATION <br /> b'•�!l0 ryl <br />