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� . <br /> SAN JOAQUIN COUNTY <br /> w y� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • 4ti�ow�`P Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.s gov.ora/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Date: <br /> Name of Facility: ce'G "X. Cit dip Code: <br /> ' -7 y. cI <br /> Address: Telephone: <br /> s <br /> Owner/Operator: <br /> i <br /> Program Element: Program Record: Inspection Type: <br /> B180 Posted ❑Yes ❑ No Permit Posted ❑Yes ❑No Re-Inspection on or After: <br /> ,OB SERVATIONS'AI D:69RRECTIVI* ACTIONS <br /> rut- arn A- a <br /> end t <br /> � - -- i <br /> pNwao�_A__ <br /> f� <br /> s <br /> P; r f <br /> ` <br /> It e . -ocat�on• Temperature ltetn,l Location °>Tempera#ure <br /> I <br /> Food Safety Certification Facility Hot Water Temperature T 1Narewashing <br /> y Name: Hand Sink: of Chlorine: ppm Heat: F <br /> a - <br /> Exp.Date: warewashing Sink: of Quat.Amm.: ppm Other: 'F <br /> Received By/Title: s <br /> EH Specialist. z i _ ,n Phone: <br /> Time in: � I ]} <br /> Time Out: Page of <br /> EHp 16-24 (21"pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />