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oP4V.tf+, a SAN JOAQUIN COUNTY <br /> 2` y <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �9< Foaa;P. Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: -ky_0_',t. to.T� Date: ;2-1 _I y <br /> ddress: 'to II+*- *L �'*,P'+ City:—r Zip Code: 537 44 <br /> wner/Operator: R r, <br /> • YL Telephone: 1J 3-- 3 3 <br /> Program Element: 1407-5 <br /> Program Record: p ,b 5 r 8 g I Inspection Type: R-L i <br /> B180 Posted VYes -1 No Permit Posted Wes ❑ No Re-Inspection on or After: <br /> 7 <br /> U i O (tet. H o°n - -, !f <br /> t u�� <br /> r <br /> Name: and Sink: =F �rin ppm Heat:aashmg Sink: =F mm.: ppm ther: .F <br /> I <br /> eceived By I Title:H Specialist: -^[ln Phone: &\53-'78 I <br /> Ime in: 11( eo l Time Out: I Q Peg of <br /> n° I <br /> EHD 16-24(2pg) 4/3/'13FOOD PROGRAM OIR CONTINUATION <br />