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SAN JOAQUIN COUNT <br /> «' ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • 8... _�_ ;P Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> 9t%FOPS <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: cO\ Q 2 �Ir_ \W v Date: 1 <br /> Address: 't bscl \ �-�- CI : Zip Code: a 5 Sb 4 <br /> Owner/Operator: Q - Telephone: t85-2-- 1 <br /> Slee <br /> Program Element: b23 Program Record: l Inspection Type: ?�^ <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> "� t +`� \�nl e toe a�. cvv - -- ( n✓et <br /> 1 <br /> z2'\— - o...lL.%� <br /> o d_e-. '. Inv S %1 <br /> o k� s t <br /> r\ 3S — <br /> Food Safety certification i Facility Hot Water Temperature War <br /> ewashing <br /> Name. .Hand Sink: '.F ,Chlorine: PPm Heat =F <br /> Exp.Date: arewashing Smk: �l of Ouat.Amm.: PPM <br /> Other. eF <br /> Received By/Title: <br /> C - <br /> EH Specialist: m - - Phone: 1.1 <br /> Time in: 1 �' .t 2 Time Out: 1` ��c '1 Page of <br /> 4D 1624 12n Pg) 4/3113 FOOD PROGRAM OR CONTINUATION <br />