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SAN JOAQUIN COUN*W <br /> 1•�'A <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> i4..,. .,...;P Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.S0goy.orD/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT 0 <br /> Name of Facility: S .. y P u M( 1 y Date: <br /> ddress: 1 Y ,� k, city: (� t t Zip Code: <br /> wner/Operator: U ' J p 00 (/ Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> 58180 Posted Yes No Permit Posted - Yes - No Re-Inspection on or After: <br /> TIONS AND CORREC NS ` <br /> GI G; I • l 11 (46. Wk,1 '- 7 , n V _. rd haj <br /> n )hcu 4 h rM ; <br /> O , h 8 hoi,,irs <br /> Or Vri r : I• ljgy e Su $ U G10Sctr ¢ <br /> S' rePd o. . P- 64b- Pyo <br /> 6MM <br /> Name: nd Sink: of hlorine: PPM eat: of <br /> Exp.Date: ewashing Sink: eF rust.Amm.: PPM ther: of <br /> Received By/Title: <br /> EH Specialist: ' Pho e. L'/ � , 3 <br /> ime in: Time Out: Page of <br /> EHD 16-24 (2-Pg) 11/7109 FOOD PROGRAM OR CONTINUATION <br />