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ara+eln. SAN JOAQUIN COUNI`. <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> 4. Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siaov.org/ehd <br /> A1Edk`' <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: G.1w IMC ar Date: <br /> Address: ,O City: Zip Code: <br /> Ue.V1 tel. s 33 <br /> Owner/Operator: uo� Telephon - 7 <br /> Program Element: �-7 rogram Record: a I`3 P s G 2 3 InspectionType: <br /> 81e0 Posted Yes _ No Permit PostetlK Yes No Re-Inspection on or Atter: <br /> S / San ej _ d� - <br /> O <br /> 'c-r-M S <br /> -7 /f16Z A-5 <br /> 6 s--&-e Fafm5- i <br /> 'j4 AcT FitSEn ri ZVT Z 7 - <br /> G KC4 OP <br /> via -IzftS30u <br /> 4-em . act /' - <br /> 3 <br /> AA <br /> On I ffi <br /> pDete: <br /> nd Sink: 'F hlorine: Ppm eat: -F <br /> arewashing Sink: 'F uat.Amm.: ppm poor <br /> -F <br /> Received By/Title: <br /> EH Specialist: <br /> Pho _ 8, <br /> me In: �-; OU Time t: �; Page of Z <br /> EMD 1624 (2-pg) 11009 FOOD PROGRAM OIR CONTINUATION <br />