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�4ftY• <br /> SAN JOAQU{N COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.orglehd <br /> Ci�dtizN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ✓� M0,r-k .+ Date: 31 _OF <br /> Address: 1/trf City: &bW <br /> Zip Code: 6a !)6 <br /> Owner/Operator: Telephone: <br /> 14 7i It <br /> Program Element: A ProgramRecord: • o Inspection Type: <br /> � U V i. <br /> 8180 Posted Yes ❑ No Permit Posted 'Yes ❑ No Re-Inspection on or After: <br /> e a s» a 2q yyyyyy. � E uVs �:,��u``y���{ ° //�(�(ll.....11//(( T�ly��.rta� •l °� #k y� <br /> IN <br /> /-114 o m /44 P1 roj i�c�a�d > rwl�_ # <br /> r k - o!d -has 10 <br /> OYk KX07 . 'qa= 4e ) &Dwi I'Aq <br /> • lLe tZe or g-_ dale— t.Jr-$ /02 Q <br /> U�8 vi 1& 0 mod JA dr ,o ab4lm .a.j AZZY7r <br /> pp <br /> � 69 e•[ R3 r,& 4,y, A4 nXA /7"eQQ <br /> ,,vee <br /> C a oy i-A r'o c <br /> :,° er11 ?l fEfe ' sits f!Ec�. txn,m ` rtp®rture lrIl ,x <br /> i <br /> I <br /> fictory g` <br /> Name: S.CE Hand Sink: •F hlorine: ppm Heat: .F <br /> Exp. Date: arewashing Sink: •F Quat.Amm.: ppm ther: •F <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: Time Out: Page of <br /> EHD 16-23 (2n°pg) 11106108 FOOD OIR CONTINUATION <br />