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> .o� SAN JOAQUIN COUN.4 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax.(209)464-0138 Web:www.sigcv.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 00, n I r L^ Date: <br /> Address: I y9 y 101 k city: —r u c 1 Zip Code: 953 7/ <br /> caner/Operator: 11 l Telephone: <br /> u, VgnS Uh�wi yrr <br /> 3S- $6GU <br /> Program Element: I/ Program Record: f 2 1 yzs Inspection Type � <br /> : . <br /> b J <br /> SBt80 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> h5} ___ l� s11 a l on S Cc,C f n c I r cf e 1 elf <br /> / <br /> r _.._ .....-- ---- <br /> 1 ,' <br /> WArtWaSh: r UfaICi- __Nj i_ 1_.-.-.-.-.- .. r .dInen4 hNnn. n <br /> 6 F. Co, rd. <br /> Name: 7Handk: ofhlorine: PPM Heat" A aP <br /> Exp.Date: arewashing Sink: `F uat.Amm.: PPM ther: -F <br /> F <br /> ived By/Title:pecialist: Phone: 41 G� J4 <br /> in: 11, <br /> Time Out: 1� Pagel of <br /> EHD 16-24 (2m pg) 4fS13 FOOD PROGRAM OIR CONTINUATION <br />