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SAN JOAQUIN COI 'Y <br /> ?a ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c4.. ip Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s4gov.org/ehd <br /> �ikoR� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: -�, `, 1.(,o_ #7 ( J Date: 16- d* <br /> Address: 7; City: Zip Code: <br /> r <br /> Owner/Operator: Telephone: <br /> Program Element: /S Program Record: it �/� Inspection Type: <br /> S8180 Posted Yes No Permit Posted Yetis No 1; Re-Inspection on or After:,(-L <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> VW "Wuyu -- _ <br /> Item/Location Temperature j Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: Q 0 <br /> of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: fr I d <br /> Time in: I Time Out: Page�f Z <br /> EHD 16-24 (2n°pg) 4/3/13 Y FOOD PROGRAM OIR CONTINUATION <br />