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SAN JOAQUIN COUX�Y <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sioov.oro/ehd <br /> ��FOP <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Chl .S dAe Clte rat• Date: �• ��, �� <br /> ddress: ' If^ Sf City: r 1 Zip Code: C�S31L <br /> Owner/Operator: DW S. J1 Telephone: 8. 7q6 I <br /> /� 4 n <br /> Program Rord: Inspection Type:Element: l602 SR6o7yas /f A I t o <br /> B180 Posted «1 Yes D Rermit Posted Dyes 01 Re-Inspection on or After: <br /> I X.: n )ct WS c ,, bH 16 , r <br /> n I1Aj 4 0 1 <br /> 2) floor- 8 : n K IuC )Cs a <br /> Gtr a r I a ; n <br /> 5 M G 6;-1'K 'S AIJ <br /> Co art Ci ' n t )e3- <br /> 00. J? <br /> . .fIIu a OnceuArefs a r been i <br /> Nin ,�U e- a % <br /> or p eeea 162 ? <br /> 1 10 0 ✓ I I <br /> yi FSA b aveWS be h /--r <br /> G �•in <br /> 1 .2- placer 3 L'f <br /> -32 rf <br /> Name: / and Sink: 'F hlorine: PPM eat: 'F <br /> Le $ r Crn4nifCZ OU <br /> Exp.Date: S , arewashing Sink: 1 2U 'F uat Amm.: PPM ther: 'F <br /> Eeceivede: If Phone: 411aL.3/6 yO/D.•S 9 Time Out: .2 5 wm- Page of <br /> EHD 1624(2n°pg) 43/13 FOOD PROGRAM OIR CONTINUATION <br />