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SAN JOAQUIN COUNT*,. <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sigov.org/ehd <br /> ad' <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: J% o Ttu<k VM74 Date: 3 _p/_/ <br /> Address: Q 2 Z E /O/'I7ta e RVA City: Zip code: <br /> Owner/Operator: Telephone: <br /> Program Element: Al Program Record: /J 56 7 Inspection Type: <br /> 8180 Postedp<Yes _ No Permit Posted xYes No Re-Inspection on or After: <br /> id R <br /> AtZi <br /> n►' a s� o�r� c r/erl �o �. �� _ <br /> -�rnvMs s � <br /> C(oo/ 406F JAIdGirl alcor- F/�P /O'F <br /> r d uCi 1r sa <br /> Name: AIM and Sink: /O5- -F hlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: s =F Ouat.Amm.: ppm ther: aF <br /> Received By/Title: � <br /> EH Speclallst: ��] Phon <br /> me in: Time Out: Z O Page of 2 <br /> EHD16.24 (2-pg) 11/2/09 FOOD PROGRAM OIR CONTINUATION <br />