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SAN JOAQUIN COUN.d <br /> a' <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: p on d Date: <br /> �" I, _ <br /> Address: <br /> lqlq WIJ l n S} City: r a d Zip Code: 9 <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection TypeVGA /1n C <br /> SBt80 Posted a No Permit Posted es No Re-Inspection on or After: <br /> IVA so OBE111 <br /> r' <br /> �---. Au.; ld--. IV-� C C" b-.nL Is and on Ilealco <br /> C <br /> / il_-_ <br /> __.........._----_.gle-.- ...-__- O o d U /� O a : rl IP G e A I61 fZ14 V^ . <br /> 0 n rvt a 1 A n 4 _ <br /> ____.____-- _� U r ��q_^_._f n we r' K YYI <br /> Js1ur +orn n S� ve�_a�--- lac- {'' N— `t -- J /Y! n jjj <br /> o 601 11 V00 .Q. S ac a // <br /> i12 to a A C. bl * K rq } Cr W, Ih // A Sn1 : � <br /> G I. al% r reCl 4ozlca <br /> Tr " t roWorl GS lee 1. Re la r <br /> L n Wee J6 <br /> Food Cfo - ^ III Tj Gn Pr C/ 4o emu <br /> 1_ <br /> G 1 l O vie � i r' 4c C? Soy /i An a' <br /> ren r ioL&4nj AP14 yeo,r l/ rPee ✓c cl <br /> TrN ( l'(100r) —)tie r2, Go j <br /> SoC � SFr 7YNe �a.dc'C. ) yl F <br /> Name: j��11\ Ilan Hand Sink: 166 #-'F hlorine: ppm Heat; `F <br /> Exp.Date: I arewashing Sink: O "F :LAMMppm ther: "F <br /> Received By/Title: <br /> H Specialist: _ Phone: <br /> _. .-.._--__—.-.-.._-..._ – <br /> ime in: / d Time Out: J _ G Page of 1 <br /> EHD 1624(2n0 pg) 4/3113 FOOD PROGRAM OIR WNTINUATION <br />