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L <br /> SAN JOAQUIN COUNTY <br /> rr z ENVIRONMENTAL HEALTH DEPARTMENT <br /> b . S <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sioov.orcl/ehd <br /> ,CiFO R� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: U S _ J c n 1;"•M u II �� ` h S c c;, I Date: /L - <br /> City, j a zip code: <br /> Address: '� o <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> B18O Posted :]Yes ❑ No Permit Posted 0 Yes 0 No Re-Inspection on or After: <br /> l CDrbo..-. rd' I• 1 o✓t oil A $ fbn I b .GI <br /> O f7r <br /> Lce b'; l --p 3C Q <br /> irk Cr I k- , n 1r Re M <br /> Sr4A;I , 1 2 60 k Wu K- ")- 36 P <br /> I rc ( oor_ ) q1 F rruC 4/ F <br /> Orow,.s a) Orr � I r <br /> r 1,. .!ej 1 /ls WGrMer 13S_ISU6 <br /> ireyl <br /> 13-Joj F Trus (M;IKI q F <br /> ame: Hand Sink: /U�r `F hlorine: ppm eat: 'F <br /> Y " ;IN 7fIG 1•e M� v.^ <br /> xp.Date: arewashing Sink: 'F uat.Amm.: .206 ppm or: "F <br /> Fime <br /> ived By I Title: <br /> pecialist: - Phone:in: Time Out: D Page�o z <br /> 1 uf- <br /> EHD 16-24 (2-pg) 4013 FOOD PROGRAM OR CONTINUATION <br />