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X0.1•'•4 .CSG SAN JOAQUIN COUNTY (Z� FlyENVIRONMENTAL HEALTH DEPARTMENTwJ' <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.si4ov.orq/ehd <br /> �lFORt� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: —� �^ f 2 Date: ' <br /> Address: ,l 1 (ee City: G Zip Code: <br /> Owner/Operator: Telephone: <br /> V o <br /> Program Element: � ogram Record: ` b . L Inspection Type: <br /> 8180 Posted ❑Yes ❑ Permit Posted ❑Yes ❑I Re-Inspection on or After: <br /> �BSEf3 ATIONS AND CORRECTIVE ACTIONS _ <br /> ... _ <br /> '�- <br /> �� C �Aj'o'el 01�k <br /> c�• <br /> V o­q'\ -'F�Y <br /> � `. \ 1 •tr-=.c.� 5 ..?a..cw -fie � <br /> o f 'L `F r )"!k . <br /> Y 2 <br /> 1 Q S� (� o <br /> Abse <br /> VJG�- <br /> k-10 F <br /> S i t cpm 'A <br /> I.WWarewasbing <br /> ame: �V and Sink: ® of hl rine: S^ ppm Heat: of <br /> xp.Date:: 1 r^1^ `� arewashing Sink: t aF Quat. mm.: ppm they: of <br /> Received By/Title: �tJ <br /> H Specialist: Phone: <br /> `fib , �. <br /> Time in: q Time Out: ,_`� , Page of 2- <br /> END 16-24 (2m pg) 4113/13 FOOD PROGRAM OIR CONTINUATION <br /> Sr. �gyp•c,_..J� fit^S C' Grl <br />