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SAN JOAQUIN COUP <br /> �-� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> �/FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: (,1 O a� S' a_r u Date: 5 <br /> 119 <br /> Address: to I y Pa-C4 <br /> 'C,/�4 City: 5 5-� Zip Code: 952-07 <br /> Owner/Operator: f sorl Telephone: *3'-). <br /> � -6-q 6 <br /> q s c�mGi �1 o h n <br /> Program Element: Ito 2 y Program Record: P A D I(4 07 to 8 Inspection Type: n _ <br /> Ff8-oposted Yes ❑ Permit Posted ❑Yes Wh)b Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> . ,! O Y J2_ <br /> 5��JK:. W�-�1� �r'c�,� ' boar-A tl 1'Y1A v-�- d <br /> W 4+1 4 zo c-4 W -fie r 5 hex,U +e h,4- <br /> ✓�e-1-) `^ loot 5 Co e- 1 ' <br /> ✓aI:JP // co o�r- c'► <br /> rAxin, :5-f" Ir -e- '1"�v0 r5 5zG.l S.Z. C.YLG I'C.l_3 off -r-100r\ ' <br /> �-t q.,-}- Yo o ►-n � f�-�,�r� •�a,t,.T V r,c�.2�•. <br /> CD <br /> Y l i ldyUyt 0 r s <br /> SaI-!n.o -1 <br /> ' ,� r ►-�+ -t u <br /> r� �--f- <br /> L�r'e coo Y-� �bLY 11 2-2 00 m Gf-1 Co r i <br /> 15 c.)0 f U c1-r O v c� d cI <br /> t: <br /> "lln0l n <br /> ae a d •,max , 12t ,- a\,,ce wayewQsk_.n - <br /> two ve ' - r 5tv✓� a.+ Imo' <br /> O Y vv ✓ 4 <br /> Y io r Y (.0 v� YS 6 I <br /> 71 <br /> `e L Y V L ao �I <br /> V o-e a I <br /> U -r 4U -,e e�n`x-4-eln� ci I'LL,� 1�' ca la y d owl o of Q <br /> . -. <br /> Item/Location Temperature Item/Location Temperature <br /> I <br /> Food Safety Certification Facility Hot Water Temperature Warewasbing <br /> Name: Hand Sink. oF C lor' a �� Heat <br /> W kr �p0 ppm 'F- <br /> Exp.Date: Warewashing Sink: aF uat.Amm.: ppm ther: of <br /> Received By/Title: pn.�rl <br /> EH Specialist: 1^ Phone: ��Tl <br /> Time in: Uu� Time Out: 0 Page( of / <br /> EHD 16-24 (2°pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />