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)p44�cOG <br /> SAN JOAQUIN COUP' Y <br /> Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: I • 0. Y. nA. Date: 9 —13 <br /> ddress: 1842. <br /> � t —/- City: T�Q Zip Code: 9 5 7 <br /> Owner/Operator4-) ���� I Telephone: 30.x_�)al I <br /> Program Element: U,,Z Program Record: p (3 D56 S 1 ,7 ;;L_ Inspection Type: <br /> 3B180 Posted O Yes ❑ No Permit Posted ❑Yes ❑No Re-Inspection on or After: <br /> -{ V C49(OtA GY16 W/1-i h C - 3 D-/ Cts) <br /> Co YAfto c0i <br /> Cl) G d h a•1- 14 ° <br /> ,EF' b w <br /> Name: Hand in 'F C ovine: "O ppm Heat: 'F <br /> Exp. Date: arewashing Sink: 'F Quat.Amm PPM lother: 'F <br /> Received By/Title: CTf <br /> EH Specialist: �^ Phone: <br /> ime In: .1 5 Time Out: �6 Page of <br /> EHO 16 24(2-pg) 4/3113 FOOD PROGRAM OR CONTINUATION <br />