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• SAN JOAQUIN COUNO <br /> w' y< ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 1� <br /> Telephone:(209)468-3420 Fax:(209) 464-0138 Web:www.sogov.org/ehd <br /> INS� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: — 8- \ _ Date: M 1_ <br /> Address: 1c�20 1 ` I& 5 City.— zip code: 9 5 374„ <br /> Owner/Operator.�Q \S \L- Telephone: s5- b <br /> op <br /> Program Element: 1\O-LS Program Record: Inspection Type: n _ <br /> 8180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: ,C-J <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 7 <br /> 2 h n t <br /> 16- p <br /> 3 C 1 <br /> -4t= <br /> '2— c1.�s� 3� )_ v V-o 15 11= <br /> k," 1 32 <br /> Item/Location Temperature r--` <br /> Sh(e c 1 �A OP 1c� F <br /> \-ICI F I-,o— <br /> h�� -L _ 1s0. 1 bo <br /> Food Safety Certification Facility Hot Water Temperature > Warewashing <br /> Name: - \ .�'�--r Hand Sink: l O of Chlorine: PPn1 Heat: ,F <br /> Exp.bate: ` 1, 1 T .0 ( arewashh Sink: \,2 aF uat.Amm.: ppm Other: 'F <br /> Received By/Title: _1 <br /> EH Specialist• _ Phone: '4 <br /> Time in: \ 0S Time Out: 2 Page,51 <br /> EHD 16-24(2w pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />