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ots ln. " SAN JOAQUIN COUNTY <br /> 2r' ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> ai <br /> _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www sjgov org/ehd <br /> 4t1 F d a`' <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> EPs - <br /> OBSERVATIONS <br /> : {/e - Date: / ' , <br /> Y.� f }L City: Tr�� Zip Code: Q! �� <br /> : J _ Telephone: g3J3. 3�.3 <br /> 4rJ Y� p <br /> t: ( Program Reco00 6 30 Inspection Type: F! he i <br /> G Yes i7 No Permit Posted ❑Yes ❑ No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> W- O6 n tec 10—V 'xenjg <br /> IP/'o Ut0/0 wrou <br /> Or SA a r roo h1 2 AJ <br /> Pr <br /> a PraVide- l20•F wolrr i r if Woe X <br /> 7 Idvtde U loch id Or he 4a1iv rr <br /> WPP K. <br /> ptap4a OGd Ima rl : , cal. 6o J <br /> 6 <br /> 0• errn 0 il re re e3 /1c Ve blae AGi <br /> pie 4urri to <br /> I D I IQ G ro r Re . <br /> Item/Location Temperature Item/Location _ Temperature Item/Location` Temperature <br /> Food Safety Certification Facility Hot Water Temperature _ Warewashing _ <br /> Name: Hand Sink: of Chlorine: ppm Heat 'F <br /> Exp.Date: Warewashing Sink: aF Quat.Amm.: - ppm Other: =F <br /> Received By/Tit <br /> EH Specialist: - Phone: - <br /> Time in: , 3 Time Out: Y17 o Page/ of <br /> EHD 16-24 (2na pg) 419112 FOOD PROGRAM OIR CONTINUATION <br />