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SAN JOAQUIN COUNTY <br /> ?< ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ad... `,...;P Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.siaov.org/ehd <br /> CIFORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: A h ,5 6 h o b Date: <br /> ddress: y y y 1III-, ss City: F r a c Zip Code: 9s '7'e <br /> wner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> ORO" me. <br /> 8180 Posted O Yes 11 No Permit Posted ❑Yes 0 No Re-Inspection on or After: <br /> f S1; a h 6 le ao �•� <br /> 016 6JOVes rd's 1 bf IASEd ral r i o aNsn 11 <br /> uth-%^ <br /> ame: and Sink: <F hlonne: PPM r <br /> eat: aF <br /> Exp.Date: arewashing Sink: YX# 12,eF uat.Amm.: PPM r <br /> Cher: .F <br /> Received By/Title: <br /> EH Specialist: ' Phone: <br /> ime in: Time Out: Pag� of 2 <br /> EHD 16-24(2n0 pg) 4013 FOOD PROGRAM OIR CONTINUATION <br />