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SAN JOAQUIN COUf�� <br /> y� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ... ;P Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> "4��FO.R is <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: T �vI lei /' Date:fry) C� <br /> Address: I Y ( I�\ I t_- City: TrG1C Zip Code: C)� <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> ha �`— (A A 61Pr ✓9C � :, W )rr �l'A ��r, C le c4 <br /> ud <br /> j 1P <br /> Item/Location Temperature Item/Location Temperature <br /> _...-- -...._._ ...._.... --— -. .............._.-- <br /> e cc YJ <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: £C4 ore/1 Hand Sink: 'F Chlorine: ppm Heat: `F <br /> S(� b� _ <br /> Exp.Date. t Warewashing Sink: �F Ouat.Amm.: ppm Other: F <br /> Received By/Title: 4 V'/ <br /> EH Specialist: Phone: k_?/6 <br /> Time in: 1 Time Out: Page of <br /> EHD 16-24 (2n°pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />