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SAN JOAQUIN COUNW <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www sia�hd <br /> c1FdaP <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> c Date: It <br /> EFat Q U S V N k h `� Cih vv I Zip Code:13 � tW5 Woo S Ulud City: SIdCn�onTelephone: ys em U S � , ion Type: a <br /> t: 0 Program Record: Q U 3 7 Yes ❑ No Permit Posted -Yes ❑No <br /> Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> --- <br /> k ' S ; rnae Id fr. Old/ G n 010 a 4"r� <br /> m p. <br /> COo Are_ 6e7.� <br /> J . - I. te(e ' vis r n <br /> S u 1 r <br /> rem <br /> h he food a0_1 Are oale, If. � <br /> %)7pS j jps C a eta IWrn <br /> Ro✓cColon J.)kon <br /> r%_�paX¢ �M ark <br /> '.t LocatTempereture <br /> ion Item J Location °Temperature <br /> .Safe. ....::: . , Facility.Hot Water Temperature Warewashing <br /> Certificatipp', <br /> .r ---- _----- --- <br /> Name: Hand sink: of Chlorine: Ppm H 'F <br /> xp.Date: arewashing Sink: oP uat.Amm: ppm 'OtherF <br /> Received By I Title: LA__ \1jV.NA__C0� 5)aLU I I <br /> EH Specialist: Phone: / =P, <br /> FOOD OIR CONTINUATION <br /> FHD1623 (2i°pg) 11106106 <br />