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aP441fY, o �"� SAN JOAQUIN COUNTI'f'� <br /> ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> r. < <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> a4..,. .... P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s'gov.org/ehd <br /> �rFOR� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: L,\\ \`! Date: y <br /> Address: yA 1E City. \ fCA Zip Code: 3-�1 <br /> Owner/Operator: e S SY�_ti� Telephone: T <br /> Program Element: �_Z\ Program Record: \b\ y 3y Inspection Type: <br /> SB180 Posted))"Yes [I No Permit Posted JkYes 0 No 1 Re-Inspection on or After: <br /> SG <br /> \2 �� Q,F <br /> 'perature <br /> Fpod Safe 'on - Facility Hot Water Tem `L .• <br /> Name: �1_ -- Hand Sink: eF Chlorine: Ppm eat: =F <br /> Exp.Date: �� _ , - Warewashing Sink: _ `tF Ouat.Amm.: ppm or: 'F <br /> Received By/Title: _ <br /> EH Specialist: +^ Phone: y <br /> Time in: -2. v Yri/ Time Out: O Page]f <br /> EHD 1624 (2W pg) 11/2/09 FOOD PROGRAM OR CONTINUATION <br />