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SAN JOAQUIN COUt�-4 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax.(209)464-0138 Web:www.suov.org/ehd <br /> L/Fdlt� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: �G. Date: <br /> Address: ` City: Zip Code: <br /> Owner/Operator: Telepho _ <br /> i <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> _.. �cJ �X.�✓�v�' !Y 7/(�.F �,D�i'Li' /Y7G�Pf c/�� �\lw�C.�i�//P� <br /> 1441 <br /> �r <br /> F <br /> Temperature Item/Location Temperature <br /> Food Safety Certification Facility Not Water Temperature *r "'' Warewashing <br /> Name: 'Hand Sink: '.F._Chlorine: ppm ';Heat: .F <br /> Exp.Date: f Warewashing Sink: of Ouat.Amm.: ppm 'Other: op <br /> I6 <br /> ecelved By/Ti : �l (rf ff <br /> H Special' Pho : <br /> .Gd <br /> ime in: /- Time Out: ��� Page i <br /> EHD Ir 24 (2n°pg) 4/313 FOOD PROGRAM OIR CONTINUATION <br />