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E <br /> I <br /> SAN JOAQUIN COUNTY <br /> r.. � ENVIRONMENTAL HEALTH DEPARTMENT <br /> r0: e i <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> �d.,•r ,.�;;P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> LrFaR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: /9 Date: ` r� <br /> ddress: �"( Q' yi City: Zip Code: 96 <br /> Owner/Operator: Cab DD�!f L +bft�dle . one;?&--/_ 33 <br /> Program Element: �u• rogram R ord: �ap�� Ins ection ype: <br /> O <br /> 8180 Poste Yes ❑ No Permit Posted es © No Re-Inspection on or After: <br /> Leg <br /> a." _� SY s..vf t.. ?f �7�a.�� ��a.►1-�1.%1+Ba7 �i � I Ai x� �,��. � �'�,9��' <br /> 3/63, (-/ <br /> F r <br /> p <br /> �:- arc <br /> hA <br /> vee <br /> tl <br /> N 'w:gx�..4 J .... <br /> ?•.' -,i a +s._ +pa' Fe'x'k {X.19 yt ✓ .,..c.. <br /> �?7' pi4k1 h <br /> Name: Hand Sink: of Chlorine: ppm Heat: OF <br /> Exp.Date: r arewashing Sink: OF Quat.Amm.: ppmOther: OF <br /> Received By 1 Title: <br /> EH Specialist: Phone + 9) V —033 <br /> Time in: Time Out: /fps^ Pagel of <br /> EHD 16-23 (2n°pg}07129/09 / FOOD PROC RAM OR CONTINUATION <br />