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SAN JOAQUIN COUNTT' <br /> a ?� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> .._ a Telephone:(209) 468-3420 Fax.(209) 464-0138 Web:www.sigov.org/ehd <br /> 4Cl F 00.N <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: (J S Lk� S n Date:• - I(J - /� <br /> Address: I Llh 54 City: It r Zip Code: S 76 <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: RUN . I1p <br /> 8180 Posted 0 Yes G No Permit Posted Ci Yes ❑ No Re-Inspection on or After: <br /> Shared hood s.nKJ Wc,r u5 h fe 40 <br /> i5 eaK� � Cr, r• Y 2 wv eK <br /> tion _. Temperature Item/Location ( Tem iature <br /> U• <br /> Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: ; IHand Sink: r 4. eF hlorine: PPM Heat: F <br /> � <br /> Exp.Date: arewashing nk: ' f "F Puat.Amm.:- PPM r <br /> ther: 'F <br /> Received By/Title: C <br /> H Specialist: 7 - Phone: <br /> Tim in: �1 : Time Out: b Page JATION <br /> EHE 1&24(2n°pg) 11/809 FOOD PROGRAM OIR CONTI <br />