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at='nu'h•.o "' SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> 8•.. Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sioov.org/ehd <br /> 'tGl F dM1N` <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: A L'r, _ r Date: (o -12 _/ <br /> Address: 32-C, i•x_. .• � City: C Zip Code: <br /> Owner/Operator: � .v� Telephone: <br /> Program Element: . Program Record: y 16 3 Z3 S G 2 3 Inspection Type: <br /> B180 Posted _Yes N Permit Posted Yes LINO Re-inspection on or After: <br /> r <br /> fie -Q ho CA-r lt't ] 1 I ' <br /> ode-s-fa camock <br /> L Ca m,pv z, a n p F-a r nes <br /> e - O t 5 <br /> Lg C 6_ Slaw Ked <br /> k4iI k le lo6'F- <br /> a', <br /> e !h <br /> D P - S iJD p a <br /> w.u a <br /> . -ow• ri s a u CSS f S <br /> S I vja u _ <br /> a hA FC4,f Mg L_ <br /> GG E 20 -ole hL <br /> le Va <br /> o <br /> c � c rA. — o - <br /> pxp.Date: <br /> and Sink: 'F hlorine: PPM eat: 'F <br /> arewashing Sink: -F <br /> Oust.Amm.: PPM ther: "F <br /> Received By/Title <br /> EH Specialist: �_- Phone: <br /> IT ime in: Time Out: PageJ7- <br /> EHD 16-24 (2-pg) 11009 FOOD PROGRAM OIR CONTINUATION <br />