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SAN JOAQUIN COUP <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> 4/FOR ` <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: C r l W I n -j Date: <br /> Address: ',jj City: 40oL-tbT Zip Code: 052liiIo <br /> caner/Operator: v r '(rcW !1 1 ti I Telephone: ' �C _�-31O <br /> Program Element: 1 Program Flecord: O Inspection Type: <br /> 8180 Post Yes No Permit Posted es No Re-Inspection on or After: <br /> 1 WVwpeor — WVSt t <br /> 1we 7 r`C) COICI vi lh en tS cm. <br /> imcooS, Cern doqsr to 1 <br /> US. - i-i male Xj 2e2"'_ Q.r \' 111 CAA . <br /> (t' - CG f-' &-tre IR a <br /> 1 <br /> rS CeA t - CA 'in <br /> 1 n c" noF ova-IIO'k - Ramirilin A CSTU <br /> t 11 S . <br /> �FWCW ChICAW, 4etk_ S <br /> C um <br /> f\ cim <br /> .r�'. Facility Hot Water Temperature <br /> Name: Hand Sink: F �hlorine: dat 1 Ppm eat: 'F <br /> Exp.Date: Warewashing Sink: '`` 'F Ouat Amm.: Ppm then. "F <br /> Received B /Title <br /> EH Specialist: Phone: <br /> Time in: i 1 � C)C)Tj V <br /> Time Out: " U �l Page t <br /> EHD 1624 (2" pg) 413113 FOOD PROGRAM OR CONTINUATION <br />