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1 <br /> ata ` SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT f <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> o�<f s�ea�w Telephone: (209)488-3420 Fax: (209)464-0138 Web:www.s ov.or /ehd f <br /> FOOD,PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 6 / G Date: a <br /> Address: 1-340 <br /> 3O City: O Zip Code: I O <br /> ner/Operator: m ` ��_ Telephone: 3D <br /> Program Element: /01 gr <br /> Proam Record: o Inspection Type: <br /> 1 ddKB-180 Pasted ❑Yes K No Permit Posted ❑Yes i?No Re-Inspection on or After: <br /> QBSERVATION&'AND RR CTIVE'rACT10N$ 1 <br /> A17 100la VAf Zf A0,Ve- ?"eo,,kre :denfs In Pitt-//V-use room <br /> Of K/> a in a - ndih n n eood Lemon l,'r, <br /> / r <br /> BnWA, CM 7 k ea a <br /> d NJI-- <br /> vd e o n <br /> m SoW2 M <br /> -Hae s ` ter- 0 f- L r—k aAltonq <br /> 1 V�5 coo ®ori <br /> aa reslarwk <br /> tem/l oca on l Tamperatasre ]teml La tion _ 'tetnperati�ra [tem 1 Location` pTeinpeMune i <br /> i <br /> FOOd SatetyCertiflcation ., _ _�. Facillfyr�i�Watat 7elmperatu'Ire r, Warewasf3ing � `�' <br /> r <br /> Name: Hand Sink: OF Chlorine: ppm Heat F <br /> Exp.Date: arewashing Sink: OF Quat.Amm.: ppm Other: -F <br /> Received By 1 Title: may, <br /> EH Specialist: Phone: <br /> 7 O T <br /> ime in: Time Out: r S Page of <br /> EHn 16-23{2 d pg) 11106M FOOD OR CONTINUATION � <br /> I <br /> h <br />