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SAN JOAQUIN COUN' <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> - 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s'gov.org/ehd <br /> LiFORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: S 5 'J W e5 ate- " s� Date: 9-30.- /y <br /> Address: 3 22 �,.� er- L� City: S Zip Code: 95 <br /> Owner/Operator: `J 1A r G j_ 4 G• l Telephone: <br /> Program Element: Se Z a <br /> Program Record: T22 2f7 D Inspection Type: <br /> SB180 Posted es No Permit Posted -7Yes No 7 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 7 sele- SRro c t_ c s r g— ► s s - <br /> 1 ck e-/— 5o 4-ke- ar-0-- 7a W" a+;m <br /> C© S <br /> Item/Location Temperature Item/Location Temperature <br /> ----- o <br /> Tr\.n2 Dove 01-5,129,vy� Z Dour �,eh,A, 'ro kk%4 <br /> 37 <br /> F104- S;CY 'P I CSS i - <br /> Food Safety Certification Facility Not Water Temperature Warewashing <br /> Name: 8�caf a U S r 0. Hand Sink: r c) 0 f °F Chlorine: — PPM Heat-------- F <br /> Exp.Date: t2_I S_ 1� arewashing Sink: 2_0f- of uat.A m.: 3()vppm then. of <br /> Received By/Title: <br /> EH Specialist: 1 Phone: <br /> Time in: Time Out: <br /> l : I O PagIZotP— <br /> EHD 16-24 (2"d pg) 4/3(13 FOOD PROGRAM OIR CONi INUATION <br />