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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> �a...... . " Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siaov.org/ehd <br /> �IFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: -1 7757 Date: L/ . _1.2 <br /> Address: , ,/ I 1 r W 5� City: Zip Code: ?6 <br /> Owner/Operator: Telephone: o � 03 <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted o Yes a No Permit Posted ❑Yes a No Re-inspection on or After: <br /> NS AND CORRECTIVMI <br /> d bUcr r1 . c n Sixy Ives <br /> er" C4 bsarbort E 10 j0 <br /> 0 a e r. b'A (o S }c me n I e co rs /e <br /> L C neo ner W . }r, a 1. al, Cc rrec I 4� <br /> �Qv ',i ; r 0 .40-') 1 I ! irLl - U, y <br /> Name: Am Y, IL un G1_/ I entl Sink: d y oIF IONne: ppm eat: 'F <br /> Exp.Date: S_ _ I arewashing Sink: .1 'F uat.Amm.: ppm er: -F <br /> Received By/Title: .�� - t <br /> H Specialist: Phone: <br /> me In: Time Out: ! ;CSV Page of <br /> Io IEHD 1624 (2n°pg) 1/18/12 FOOD PROGRAM OIR CONTINUATION <br />