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SAN JOAQUIN COUIh i( <br /> b <br /> ?� ENVIRONMENTAL HEALTH <056ARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> ... " . P.. Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.siaov.oro/ehd <br /> 4�,FOR� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: EW1 Lf rlmh <br /> 5zz� Date: _ <br /> Address: / y q L s City: '- Zip Code: <br /> Owner/Operator: Telephone: <br /> c Vc, .+ S tilt^ <br /> Program Element: I Program Record: / 2 Inspection Type: nc <br /> 8180 Posted Yes - No Permit Posted Yes No Re-Inspection on or After: <br /> 7L76rBSE IONS AND CdfikCT1MjjjjNLNS <br /> l0I : un ci,e e )(e o Sc, VeE Cert : Cute ; r 6C dr ., u:n k: n <br /> t PCPr ,',e 40 0ee : n <br /> FiAcj cue" I f e . <br /> U. V 10re - ooim <br /> Per NI :1I Ual:Cl <br /> pExp.Date: <br /> clv <br /> F <br /> Hand Sink: aF hlorine: PPM Heat: aF <br /> arewashing Sink: aF uat.Amm.: PPM r <br /> that: ,F <br /> Ieceived By/Title: <br /> H Specialist: - Phone: '3 16 <br /> !me in: '� Time Out: Page j <br /> EHD 16-24 (2-P9) 11/2/09 FOOD PROGRAM OIR CONTINUATION <br />