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,o fiat SAN JOAQUIN COUNTY <br /> a t ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209)4fi8-3420 Fax:(209)464-0138 Web:www.sigay.orglehd <br /> �lROR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: o E 5 4i�nrc� Date: <br /> Address: 0 ( Gr h City: S y� Zip Code: q SZU y <br /> Owner/Operator: ( A Telephone; 1 <br /> �� �.c', �1� �1-o9s <br /> Program Element: I O0 Program Record: G D U U s o a 3S Inspection Type: 1c, n F k <br /> 58180 Posted ❑Yes ❑ No I/ Permit Posted 0 Yes ❑ No Re-inspection on or After: <br /> ., <br /> vdLa4e m 0 - I-G9 Core ar <br /> ur betue. C l.sc�e h end PeC_e e 5 hauSand..._ u 1 <br /> r -.VN C6m a; nonk 51q4ed } y, Gh:(Ye►. CO Yr )e4c1 <br /> Co o K at UJ' l h red b -eke bones. o IG;V,J.V\ t WG 5 <br /> i +M w ', po'l 50f, ro 0: 300 S- )-o9 40 <br /> 30 . w"1 �, t) t- dG �� CA �a �C� cher e, iS <br /> c o h ArA <br /> 5.1 Q, J;s; - AC,; I ; � 9 U) r U 1 0 �1 G o ►�- ; n 4 . <br /> G C: I dIO e ;0a v� 4 aro ac rA 7 Lt re.5 4 n <br /> 6CiVk E , ZeFc, c ; ii da e5 nab M Q K f bcirbec(Ac <br /> Gh1GK en k r; e W 61.,cKPn Wol5 1 Al <br /> C 0o Kc d �o IP ba Ice. LA da r- Ve c 4Ub/es <br /> P, re aua ; ! b Ie It J_ me o ns e � o►1 a n rA I s <br /> � eplet\:5 lie d e- ve rti W kOtArs ea <br /> per- k and <br /> G $ ✓1 n 4/ us abs r c+nd 1 r ce , vcd <br /> C r t; 11 00dJ i54f(AI7 %11In1'1 cf(0; hQol <br /> 0 or r- -106 G A S }a N!e r s o n �� a/G oda Gl <br /> Cofereaf in t,JaIK ' � � <br /> $ q ✓1pfl M C !' <br /> �i ?' QCBOn # n ; giYijl@Ci!>tl�l8 k v t9 � {� ;� ?"5 $ QIITerrtlY@:i c .✓ if8R1CBiOr1 K` t m. a@11118TatllTB. <br /> tj Ch:C 1C .,�_ `.5 � Swet 1A)aIk- , h �I t <br /> W Po r K6`'$1 F o f c! e c ��-dGc r y P �, aG r a y F <br /> ! hy <br /> dUS tinct IS�c.h / r <br /> ,> . e.` F�pdrS7#fety t' TtrflG8tt0l1tw; et8lf� e?1rt wn1.�.7 lief lNBrewaSh{lg�€, `may <br /> Name: 0 1• ' Hand Sink: rUG OF Chlorine. S u ppm Heat: OF <br /> Exp.Date: Warewashing Sink: 12 G OF Quat.Amm.: ppm they: OF <br /> Received By 1 Title: . <br /> EH Specialist: Phone: C/ <br /> O! f0- 3 f <br /> Time in: lo.. <br /> . 3 S Time Out: fI� .0 13 Page of j <br /> EH016-23(2nd pg) 11106108 I FOOD OIR CONTINUATION <br />