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SAN JOAQUIN COUN _ . <br /> p .. <br /> a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: TCA ( o Date: !-A - ts <br /> �r� v <br /> Address: U City: Ti- o Zip Code: 9 S3 d y <br /> Owner/Operator: �V Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> IS6180 Posted es ❑ Permit Posted I?Wes ❑ i) Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> J <br /> Un _ l,u C1 <br /> } 1-r a 4 ov- cy h eve Y 12a* r. Ccrred IG A <br /> 3ra C; I •; , /ACK.5 1 S_ Pray; in - - <br /> . I <br /> t/ d; f ) i Il rep e I'1') aLl G /,a <br /> VP <br /> iC r My,11 be Uri Orr �`� l� I <br /> San• �i Ltr- Sod f _ <br /> item!Location Temperature <br /> q Lir 01 <br /> Lficatio Facility Hot Water Temperature Warewashing <br /> Name /^ PICA Hand Sink V 'F Chlorine: ppm Heat aF <br /> Exp.Date: 2 / arewashing Sink: `F at.Amm.. ppm Other: 'F <br /> Received By/Title: <br /> H Specialist: Phone: 4 J`­�h f <br /> Time in: Q Time Out: l Page of <br /> 1 3 <br /> EHD 16-24 (211pg) 4,13113 FOOD PROGRAM OR CONTINUATION <br />