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_ 1 <br /> Q¢Qut" SAN JOAQUIN COUNTY <br /> r. '2 DEPARTMENT <br /> ENVIRONMENTAL HEALTH DEPART <br /> East b4aip-S#et— - I g6� � Ijoyl Rw <br /> c�4 z Nip. Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sjgqv.orcI/ehd <br /> LfFO� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Qufck Date: S—- Z _ <br /> Address: Ac 7 Z I City: Zip Code: <br /> Owner/Operator: 1 Telephone: <br /> Program Element: 1600 Program Record: 60013 Y Inspection Type: /0 M ela,)7 <br /> !SI3180 Posted XYes 0 No Permit Posted P Yes D No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 3 0 - <br /> ilia GASn ins! <br /> 1 ecr !� . A� a ls� <br /> Item/Location Temperature Item/Location Temperature Item!Location Temperature <br /> Food Safety_Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: 'F <br /> Exp.Date: Warewashing Sink: 'F Quat.Amm.: ppm Other: of <br /> Received B"t!EHSpecialist:Specialist: Phone, <br /> Time in: Time Out: _ Page of <br /> EHD 16-24 (2 d pg) 1118h2 FOOD PROGRAM OR CONTINUATION <br />