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g�`�U"�•..� ' ONY <br /> SAN JOAQUIN C <br /> .y, ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 488-3420 Fax:(209) 464-0138 Web:www.s' ov.or /ehd <br /> err=dr+ <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> I <br /> Name of Facility: Ur r Date: 8 j <br /> V'i VIA <br /> Address: /_ ` r ty� r. r City: L,�„arj Zip Code: 95 W <br /> 1 � <br /> Owner/Operator:lLCA <br /> (�V i � Se r �UTelephone: 7.003 <br /> Program Element: Program Record: 23 Inspection Type: t�4i YL-t� <br /> 8180 Posted VIYes No Permit PostecWes No Re-Inspection on or After: <br /> „ ABE �11A1i0. REt `A # �IS <br /> `r1-�.r_ dao r r K-i ►'! Y a k h a.Kq- a n.d <br /> r e Y1'0 4- Cx C. 'n f7;Lz <br /> �-e L r l.o <br /> z �Iz 1 v-L h Cow-d.h©cw <br /> o in a .r-, c <br /> MO c9- a r <br /> c�y t vvice � <br /> ms <br /> ro <br /> tr° <br /> g.ail <br /> ._ <br /> 6r -t ►-s !fes HVL8x r F <br /> ( dew K 61 1WY ' A 1840 <br /> sho ,,K;, � &q(I t e d bur <br /> eLl I <br /> Fuad Sade, ertif�cat lay <br /> tlt t 3R± itpr ... m N9arteWat�hinc� <br /> « ! pratu <br /> Name: _ � Hand Sink: DOi 124 ^'F C rin o20(7ppm Heat: 'F <br /> Exp.Date: arewashing Sink: i�3 `F uat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: kA17 Phone: <br /> Time in: Time Out: :3 Page of <br /> EHD 16-24 (2^r pg) 4!3113 FOOD PROGRAM OIR CONTINUATION <br />