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oPg�lr. SAN JOAQUIN CO <br /> x:�rA <br /> ENVIRONMENTAL HEALTH DEwPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> {crFdti;p. Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.siaov.orD/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: rZ (/V-.— V( <br /> Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: ./CGv V � e l� C Telephone: <br /> Program Element: Program Record: / _Q Inspection Type: V.of IP7F94 <br /> i7 <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> """`''"` ' "" '"'' `' 0MROWATIONS AND CORRECTIVE ACTIONi, i k.4, <br /> :, <br /> ,gypIIIIIIIIIIIIIIIIIM / r` , r •`, w <br /> ✓f0 �— H i'LGt Q 1 vl C�J� <br /> UlulrS rn <br /> i nxl artk � H <br /> n <br /> a w - 3 •-� <br /> a <br /> n u m <br /> rChain ns . <br /> r Arll l-10 <br /> HVi4i if 1 H c ' S hfmkv <br /> a A kW w <br /> ir►1-( f— -0 <br /> d' ov- Mom ,, <br /> A <br /> abc <br /> J ekij LL <br /> Facility Hot Water Temperature "'.=ppmHeat ame: Hand Sink: F �chlorine: eF <br /> V <br /> Exp.Date: arewashing Sink: eF uat.Amm.: ppm then: of <br /> Received By/Title. <br /> EH Specialist: ,,,/ _ Phone: <br /> Time in: 1 ' _✓ Time Out: I Page of <br /> EHD 16-24 (2-pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />