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aPA"'"• F SAN JOAQUIN COUO <br /> 1•�a'A <br /> tiA ENVIRONMENTAL HEALTH DEPARTMENT <br /> i <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> iq.,• ,,..a Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sogov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: G fW Date: 3/Nal)3 <br /> Address: (02 d W 0n0i `4'Z1- <br /> - Xca City. f uy—" Zip Code: q 'V <br /> Owner/Operator:: _ ^ - ONO <br /> r (L'�!`� J t " ' Telephone: � ( &—IclJO <br /> Program Element: I b G Program Record: � ry G b 1 Z V G Inspection Type: Y/ �nl o <br /> SB180 Posted d Yes f No J Permit Posted es I'❑-No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> KU M W0 + V)0rdWC1&h SiV -►cm . 0-rro cin <br /> vr\ S i 4e , <br /> ice s a CWrict (v7) tz %ner _ <br /> Cd <br /> 3 WC01 wwnWd i`\ <br /> NCk i- i Sr t[) a - wWe S. I,OWP.x 1r2 <br /> i S <br /> Item/Location Temperature Item/Location Temperature: <br /> Food Safety Certification _Facility Hot Water Temperature Warewashing <br /> Name: Ind Sink: 'F Chlorine: ppm Heat: 'F <br /> Exp.Date: arewashing Sink: LZu -.F Ouat.Amm.: ppm Other: `F <br /> Received By/Title: <br /> EH Specialist: Phone: [} In re) —.3 Q "+ <br /> Time in: 1 '.06-11 Time Out: ` , Page 2 <br /> EHD 16-24 (20 pg) 4013 FOOD PROGRAM OIR CONTINUATION <br />