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SAN JOAQUIN COUNTY` <br /> R . < <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ 600 East Main Street, Stockton, CA 95202-3029 <br /> cq... .,..�a Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s*gov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: (AIN I„ Date: _ <br /> Address: Ir 'J city: T rQ c zip code: <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: )?CIA <br /> SBI80 Posted - Yes _ No Permit Posted Yes - No Re-Inspection on or After: 1 <br /> SERVATIONS AND CO CTIO <br /> o o d ; n <br /> d /;h C n.+ Coire <br /> 2 <br /> 3 r o f 9 a.:, <br /> A j or4h I n Weo <br /> 1Prov-. de o I s 41, an <br /> P cn; r e <br /> IteWL r <br /> �U <br /> Facility Hot Water Temperature <br /> Name: /V 14 Hand Sink: \ Z L 'F Chlorine: ppm eat: =F <br /> Exp. Date: arewashing Sink: � 2 G of Ouat.Amin.: �m ar: of <br /> Received By/Title: <br /> EH Specialist: - _ Phone: O_�/l� <br /> ok <br /> Time in: ' Time Out: S Page of <br /> EHD1G24 (2-pg) 1/1B112 FOOD PROGRAM OIR CONTINUATION <br />