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SAN JOAQUI�N- COI.JNTY <br /> , • .> <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 EAST MAIN STREET,STOCKTON,CA 95202-3029 <br /> TELEPHONE: 209 46 - 420 Fax:(209)464-0138 WEB:WWW.SJGOV.ORG1EHD <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: q C Date: G <br /> ddresS: ! 0S /A �e City: .4 K Zip code: q S 21S <br /> 1 ,o r1 <br /> Owner/Operator: ,yy} <br /> p a i t;C / ! A d O Telephone: <br /> Program Element. Program Record: Inspection Type: <br /> SB180 Posted r Yes C No Permit Posted G Yes ❑ No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> } ' f � w J4o LIU 10-1 014q <br /> p <br /> ° 3n C214 11 S. <br /> ancq 0 � go �� o <br /> Item 1 Location Temperature Item I Location Temperature Item 1 Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature washing <br /> Name: Hand Sink: of Chlorine: ppm Heat: OF <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> ReceivedBy I Title: <br /> EH Specialist: Phone: �,/ I / <br /> ime in: Q; 1,9 <br /> 0 Time Out: .SCl Page ofl <br /> EHD 16-23 (21,1 pg) 814106 1 FOOD OR GONTINUATION <br /> 08114108 <br />