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T 4 <br /> SAN JOAQUIN COUNTY <br /> p ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.siqov.orc�lehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: IK Date: b 1� <br /> Address: City: Zip Code: g <br /> Owner/Operator: t� 02�i�1� I hone; ?7 EO �. <br /> ecti n Type: <br /> Program Element: Program Record: Ins p � <br /> Is 8180 Posted ❑Yes ❑ No Permit Posted ❑Yes [] No Re-Inspection on or After: <br /> ' S ,. <br /> .g ACTIONS <br /> l.-Ct'} <br /> H 40V <br /> 070 <br /> LlufnrA4 -A '449t <br /> AD V <br /> I-W'4' <br /> wd. YZ) <br /> i <br /> '` .# `' ;�< ��` ` -417Loragri i^- ?�f ,Temperatere t#iam'floca#ion '_ Temperature <br /> . �ppp�( q� . ° ' F . Faplityftot Wat91 Tenripat "Wa�reNrashing <br /> Name: and Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: 'F ' uat.Amm.: Ppm Other: 'F <br /> Received By 1 Title: k <br /> EH Specialist: „ Phon ?„P, <br /> Time in: . O�3 <br /> i Time ut: OOfj Pagef of <br /> EHD 16-23{2'1 pg} 071290 FOOD PROGRAM OIR CONTINUATION <br /> Ii <br /> r <br /> i <br />