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SAN JOAQUIN COUN1 <br /> y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.slgov.org/ehd <br /> �/FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 7 Date: G <br /> ddress: w Zip Code: <br /> Owner/Operator: CJ \j �� d Telephone: 7>33 r 1 <br /> Program Element: Program Record: q—_ 9 Inspection Type: <br /> 6180 Posted ❑Yes ❑ Rermit Posted ❑Yes ❑1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 1I y- <br /> wT� <br /> Z a a4— Co bMA <br /> iM <br /> Z_ar� �Q"✓ <br /> r <br /> Item/Location Temperature Item/Location Temperature <br /> Food Safety Certification �' Facility Hot Water Temperature <br /> z <br /> Name: Hand Sink: of iChlorine: ppm Heat: of <br /> V10. <br /> Exp. Date: arewashing Sink: of uat.Amm.: ppmOther: of <br /> Received By/Title: <br /> EH Specialist: Phone: Lf g b <br /> "1-- <br /> Time in: G �(� Time Out: Page of <br /> EHD 16-24(2ntl pg) 4/3/13 f(/ FOOD PROGRAM OIR CONTINUATION <br /> 8 <br />