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�k1±� SAN JOAQUIN COUNT`•:' <br /> r y ENVIRONMENTAL HEALTH DEPARTMENT <br /> J. i <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> •.. Y"s iP• Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.so-gov.org/ehd <br /> 4�i�pwN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 1r r Date: 6.-j Z <br /> ddress: pj, r v^ City: Zip Code: � :5a� <br /> Owner/Operator: /i, ns y� Telephone: 11 3 •_-LO 0-3 <br /> Program Element: lb2-4 <br /> Program Record: 23 Inspection Type: <br /> B180 Posted '(Yes ❑ No Permit Posted xYes ❑No - Re-Inspection on or After: �� � <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> M04 <br /> . l't a 0 D r <br /> 1ZI It 5 r )-Ve r 61'17 f, GOO 62..r Q d 'v-e r L +'Mo"W-- ►' . <br /> w-< < <br /> l �►"� rls ' �ioGdr'rz La j-IOin r l c r <br /> kv lee ,I -kmsI Y Ca :fir, a " 1 <br /> vJ?f .Ch _ p 6' -e re- t"o • F oer5 <br /> U n'-4e r L ra l oo r 'Le.s o Azd ce v-e d cr <br /> !� /-00)- <br /> 4 <br /> r s� Gtr s o <br /> Loon <br /> S C, 5K Lo rs 1 t , L2 ►'1�-f�cr <br /> sa 5f- `L-, r r-e-� 154 Y"C- A C1 Ma 4 O k <br /> ` Y r b <br /> 5 i G 1-0r7 <br /> La.c�e� n <br /> Yrl � <br /> L( L4 <br /> W. i - •, 1 <br /> O Kt <br /> Itemilocation Temperature Item t Location Temperature Item 1 Location Temperature <br /> h10 It ae r 182 FFc <br /> 3be� <br /> 5 a Serue. .,I` v'er or 'Lid n h 16 a°r <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: �'/ . brt Hand Sink: /0(,o of Ch►prSrlej,_-f- "o ppm Heat: of <br /> Exp.Date: �� c, r arlashi ng Sink: l!s ofr� ppm Other: of <br /> oiz- <br /> Received By/Title: <br /> EH Specialist: O_-'� Phone: <br /> Time In: 10 :2-0 <br /> 0 .n0 Time Out. r Page of <br /> EHD 16.24 (2W pg) 1!18112 FOOD PROGRAM OIR CONTINUATION <br />