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SAN JOAQUIN COUN,,,! <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �'�iFa'aN P Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siaov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: < ,,^^ <br /> d J �one LrQq r✓12r K Date: /2.19-/ <br /> ddress: I�S y I) L S.4 City: )rU a Zip Code: 3 <br /> weer/Operator: d h a r Telephone:.Sr/ t Tr411u rn:' P �3J- 7VL / <br /> Program Element: I/ z Program Record: S I S I y Inspection Type: <br /> b [ •i nJ [ ai <br /> 8180 Posted ❑Yes ❑ No Permit Posted - Yes " No Re-Inspection on or AfteIWI& r: <br /> PONS; <br /> ♦ip S rr j , C' <br /> 4; l IN {r r k" CGrrr I' <br /> 7,FOQd <br /> / 3 <br /> bui <br /> a. 11 u r k1 <br /> L, s♦r ! a <br /> VtrqW Pr'C 61 ' <br /> ame: Hand Sink: OF r <br /> hlorine: ppm eat: OF <br /> Exp. Date: arewashing Sink: OF uat.Amm.: Ppm ther: of <br /> Received By/Title: <br /> EH Specialist: Phone: 1t 11 j- <br /> ime in: Time Out: '7 Page of <br /> EHD 1&24 (2m pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />