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SAN JOAQUIN COUNT 4 <br /> �. ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> ��cfrek�e Telephone:(209) 468-3420 Fax.(209)464-0138 Web:www.siaov.ora/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: N4 Date: <br /> / U <br /> Address: I S f City: r Zip Code: <br /> Owner/Operator: V N n I� Ulu. F Telephone: <br /> Program Element: f v I Program Record: r Inspection Type: <br /> 1i '• Nc. r v0^ el <br /> 56180 Posted Yes No Per Posted Yes o Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIV <br /> 7msa U <br /> cC. Ih n ON v45-Ve + <br /> Ll <br /> tJ0r rVAN n . i n4C,: .� <br /> 1 � <br /> S r vC'rf E <br /> G 1 <br /> C11 0. C4 /; c/;SSti 6b' 3 /E <br /> IV 0)e- w0erhe,, Ier ; <br /> Jdur (prep) X)re h + - A 14 1 r <br /> :3 IG 4 v - <br /> ame: and Sink: /U CJ 'F hlorine: ppm eat: "F <br /> Exp.Date: ;rewashing Sink: U 'F rust.Amm.: ppm ther: `F <br /> Received By/Title: <br /> H Specialist: - Phone: - J,/! <br /> ime in: Time Out: O b Page of <br /> EHD 1&24 (2°pg) 11/2,09 FOOD PROGRAM OR CONTINUATION <br />