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SAN JOAQUIN COUNT <br /> Q: <br /> ' ENVIRONMENTAL HEALTH DEPARTMENT <br /> � 1 <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 L2 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.siaov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility:CO\ C e \ k Ch Date: 0-k2-1 <br /> Address: 1 Jr 1 C Zip Code: <br /> caner/ erat r: S d Telephone: sz_-14 <br /> b <br /> Program Element: 2 Program Record: S I $ 5 i Inspection Type: ��- <br /> 5780 Posted es No Permit Posted Yes No Re-Inspection on or After: J� h <br /> ACTION <br /> v <br /> " <br /> _ IG_ <br /> 1 �r0 vJ <br /> e <br /> 3 \ e <br /> i e e ct <br /> 5 \ Fo fn <br /> �^ b <br /> � F 44,,e-,42 Jr-: _ <br /> /ems+ <br /> \j ' 1 2 <br /> 1 1 d: <br /> Itern/Location Item Location <br /> l! <br /> _... t..;. __ -.. __ ......._ <br /> �1 y <br /> Food Safety Certification Facility Hot Water Temperature Warewashing " `' ';.. <br /> Name:� , Hand Sink: `v�J of [C- <br /> Exp. <br /> hlorine: PPM Heat aF <br /> Date: b_ 2-� rewashing Sink: ` ofuat.Amm.: SGO ppm ther: - eF <br /> Received By/Title: <br /> EH Specialist: A Phone: b <br /> Time in: .Z• Q Time Out: 3, 2 ^ Pa] <br /> g2 <br /> EHD 1624 (2-pg) 4/3(13 -v FOOD PROGRAM OIR CONTINUATION <br />