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"'„•. SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.siaov.ora/ehd <br /> u�da <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: _ +G Date: 2- 6 -12- <br /> dress: Zip G �. Ci I rn . Zip Code: q�Z 76 <br /> nerlOperator: Telephone: <br /> Program Element: Program Record: Inspection Type: C,U I., n <br /> B180 Posted []Yes ❑ No Permit Posted -Yes - No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> In <br /> (A C- . + ada <br /> V. I a der. <br /> Sia qhs rA 4ice <br /> 3 Icr <br /> G n �� cke d On <br /> i FO � h a a 'c A <br /> Cc, Qn i C C//ee S 4-ore d ;n <br /> t 1A C 'I'O G i C 1 I <br /> -Rrrer I n We <br /> doC i'jr` s Or hn cu . rters � n <br /> olc'. r ✓ Ccirds O S <br /> C )ire <br /> e q liMn4,1( n 4d I✓ T u'r1-111 r <br /> Food SaMty CWWWMwn Fatality Not Weser Temperature Warawashing <br /> Name Hand Sink: 1 FChlorine: ppm eat: J-FExp.-Cate: - arewashing Sink: 'F uatthey:.Amm.: ppm <br /> Received By I Title: t 11 1 V X Vkao ir _ <br /> EH Specialist: Phone: ll&,f //� <br /> (mein: Time Out:�� b Pagej f <br /> FOOD PROGRAM OIR CONTINUATION <br /> EHD 1623 (2n°pg) 07129109 <br />