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SAN JOAQUIN COUNTT <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> cq.... ....CP Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siaov.ora/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: 3C)-x0q Cay: Zip Code: 95� <br /> Owner/operator: ma Telephone: <br /> Program Element: r Program Record: Inspection Type:�d <br /> 8180 Posted IYes 0 No Permit Posted fFYes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> I a2Kih "Sv rruc , Odor b-e -f + l (-C�" r7 ADO)- <br /> 2 <br /> t Ye d - j4e r Y verd <br /> ci <br /> IJ Ntz �,f Ig,r 'k or <br /> l — <br /> C h A n a h. i ct. <br /> 00 <br /> Item/Locatiol�a' <br /> L cooLo r �l5 4F- /a1.c�rT �r l` /ar5p£ <br /> el /, y5Y o2voy <br /> " ✓ DAF l48` <br /> Name: and Sink: //O 'F rine• a00 ppm eat: 'F <br /> Exp.Date: arewashing Sink: 2 f_ 'F uat.Amm.: ppmj�Other: -F <br /> Received By/Title: <br /> EH Specialist: Pho e: <br /> Time in: /0; <br /> 50 <br /> 1 Time Out: Page of <br /> EHD 16-24 (V p9) 11/20 FOOD PROGRAM OR CONTINUATION <br />