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SAN JOAQUIN COU I( <br /> � •.OG <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.si.qov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: c-h pQ ) Date: <br /> Address: �• .1Of,1 City: C Zip Code: '9620 <br /> Owner/Operator: 6 u I C� Telephone: _1?0 <br /> Program Element: b Program Record: P R OI to T)5(03 Inspection Type: <br /> Ftil-8—OPosted Yes ❑ Permit Posted Owes ❑1 Re-Inspection on or After: <br /> an: - <br /> IIIE <br /> s tea, <br /> 4e4 <br /> n S O '?-e-4, t I m rn.e_(AA awe <br /> Y� r IT-zac� <br /> LQ VY) rpI <br /> 4i vt !tic meIII <br /> fi J-Q Y <br /> Un—t- W L <br /> 1r►o�c�.e c� <br /> v z on 0, V-Z)II bQs <br /> Q CA Y 6 of. CJ e a a 11 0,GI Y 0. 0- <br /> L u � A <br /> Pa r t,tLo sA- w CX_UV_k1 CIO in (P <br /> l j r Ct.A- <br /> LAJ <br /> rs a vc�l <br /> nL441 r►�.t 1 155 l k ni -> -4-h <br /> nA <br /> rn !_ &00 14 1'°r <br /> 1c <br /> Ll SSG d-,'Mg `�`� <br /> Il 9, <br /> 4 d <br /> MIME <br /> SEEM <br /> Name: �� /., __L H�teand Sink: �a of Chlorine: ppm Heat: of <br /> Exp.Date: W /7/ are ashin Sink 2 o f at.Am O ppm ther: 'F <br /> Received By/Title: <br /> EH Specialist: Phone: 5 7,817 <br /> Time in: Time Out: D ,` Pages of <br /> EHD 16-24 (2n°pg) 413113 FOOD PROGRAM OR CONTINUATION <br />