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SAN JOAQUIN COUMd <br /> 1•�r4'q <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.s00oy.or0/ehd <br /> u Fowe+• <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 74060 � A O 0i/P S C h 00l Date: <br /> ddress: 3 93 C1 G t'tz& Woo 013 City: S fl h Zip Code: 9S ;2 <br /> wner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: /wN/ .n <br /> 8180 Posted a Yes ❑ No Permit Posted e i Yes - No Re-Inspection on or After: <br /> pre S It 5 ei 5 .1tr0, k9 I Atr n I W <br /> N <br /> Or, L (m: <br /> rAcrlSr 1 �GYr I-) re, r l' dvc. `ll f <br /> WQrO'Ier 1JS1Wei r ftlerSF <br /> 1J a r ryl f r 13 5-)' ) - : rl <br /> NOr• La Pe. ( m; I I F r-t . '�ryii 1 e4SF <br /> :..,...:.. ._...,........ ., :.:::.._ �..:.:. .. . .....m._.,. ..,.. ...._ ....... . ... ........ :.......-.:.. . _.:.. ... ,_'... are <br /> washing ;:;. <br /> Name: < Hand Sink: "F Chlorine: PPM Heat of <br /> Exp. Date: 3 - G - I (, arewashing Sink: I Z "F C uat. Amm.: PPM Other: =F <br /> Received By/Title: <br /> H Specialist: �t Phone: _ �� <br /> ime in: Time Out: Paget of 2 <br /> EHD 1624 (2n°pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />