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SAN JOAQUIN COUN <br /> �0. 'cOG <br /> 2 z ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ = 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 7.ii Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sogov.org/ehd <br /> 7FORM <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: V ro-A Date: <br /> ddress: �� a City: D C C?� Zip Code: p <br /> Owner/Operator: ��� Telephone: <br /> Program Element: Q Program Record: �� ! / Inspection Type: <br /> B180 Posted ❑Yes ❑ Rermit Posted ❑Yes ❑1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> a <br /> �S lS nAAA <br /> r � - <br /> C r <br /> ' �' Tperature Item 1 Location Temperature- <br /> Item/Location <br /> V C2 <br /> U 00 <br /> �r _ _ Ne. /tet <br /> rro <br /> Foodz v a �� <br /> T <br /> Safety Certification Facility of Water Temperature Warewashing <br /> Name: �i �� i Hand Sink: ofChlorine: ppm Heat: 'F <br /> Exp.Date: 2! arewashing Sink: uat.Amm.: Other: <br /> U141 F <br /> ppm 'F <br /> Received By T <br /> EH Specialist. Phone: <br /> ime in: Time Out: b Page of <br /> 7_HD 16-24 (2n°pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />