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SAN JOAQUIN COON Y / vJf�ne. <br /> ` ENVIRONMENTAL HEALTH DEPARTMENT -TO(re5 <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6 <br /> • c...., r P LJ Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.s' v. <br /> U <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Date: <br /> Name of Facility: _ \ % �^t — I <br /> ddress: S.ZO S_1 CrtY: Zip code: 36b <br /> A'A <br /> Owner/Operator: -T - Telephone: 82-3_ -7229 <br /> s. <br /> Program Element: Program Record: 5 b 23� t 6.3 223 - Inspection Type:lk <br /> 8180 Posted O Yes ❑ No Permit Posted ElYes ElNo Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> \ \ \ — — <br /> V 1 <br /> 4 <br /> "rteekz <br /> s c4 C.'P <br /> 1 C Im <br /> - <br /> 3 0 _ <br /> Temperature "`' Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: LHand Sink: -F Chlorine: PPM Heat: aF <br /> Exp.Date: ewashing Sink: -F Oust.Amm.: PPM Other: eF <br /> Received By f Title: <br /> EH Specialist•- - Phone: k-k .0 „O <br /> ime in: 3^ Time Out: c-'7r-v Page; of <br /> EHD16.24(2-P9)4/313 `J FOOD PROGRAM OIR CONTINUATION <br /> T.6Crxr� <br />