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°"0" SAN JOAQUIN COU. Y <br /> Z-+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ = 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.orq/ehd <br /> ��FbR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: T y, ,YY1 ori+ A� C 1 Date: � _'5 Q _/s <br /> Address: I(O I•7 Vl) -T v-e m o/i'I— 64 City: 5+0 e ls-�,1 Zip Code: 0115 20 <br /> 5 <br /> wnerlOperator. ^___ - i n 4 d �y� ��+rn P n f 5 �p� Telephone: /D—51 <br /> Program Element: Lp Q1� <br /> ZlO� I Program Record: 5 20 0 '7 I I Inspection Type: <br /> 8180 Posted La Yes ❑ Permit Posted I_? Yes FiI Re-inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 1 ;A C ,.mac' kj-- • LU-.q '6 — <br /> mc 44 _s. a n.; 4u0t / c-Le o, <br /> �pO �S i �✓a- I S h r- w <br /> 92c1- ✓ V a-e l-c-e n 3 —Go n1 <br /> mp <br /> i L 72.p _ oLc-/-G t_.(jc . <br /> Lt kr a c l�c ✓ rn,0 s io r00 ms <br /> i n 0u i W a4464'17 coo (,4 H <br /> C'eal bin I W <br /> V ✓-� G » Zf 4)6 <br /> VV0r Lr�r� r,�,' 2 <br /> D- L'S u r '-l- 071 u S a,, <br /> / 11v r <br /> r0 R&? <br /> Y ndSi Was vn <br /> tici min 4- h q 1--K -Go r-L i4c o S -�1G 1 r�s oom <br /> y 5 K r <br /> Item/Location Temperature ' ' liem/Loc <br /> 11 ._ <br /> /2) f oca d ho L d.e,- - l 5 ev n u A'�,L� coo ® Cz r <br /> L <br /> 140 !o <br /> r -7'ra�v J so _ -- - d,►'✓nch 4- Goo 4 v 7 <br /> Food Safety Certification jj Facility Hot Water Temperature l Warewashing <br /> Name: c4 ` , p (Hand Sink: Chlorine: ppmHeat: o <br /> _1I( , 'F F <br /> Exp. Date: �� 'War ashing Sink: �� of Quat.Amm.. ppm Other: 'F <br /> 15 ji <br /> Received By/Title: <br /> ►'n-r e - CurreI7-,� ou)�r^ <br /> EH Specialist: Phone: <br /> Time in: Time Out: Page of ' <br /> EHD 1624(2n^pg) 4/3113 FOOD PROGRAM OR CONTINUATION <br />