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SAN JOAQUIN COUNTY <br /> z+ 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 /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Ef)ofhovso Date:`_.2 16 <br /> Address: oC a ,� ra q <br /> I City: 1 Y c;(` Zip Code: CI S.S <br /> Owner/Operator: Telephone: <br /> Program Element: 1 1 Program Record: ('06 <br /> 0 0 1? 41 if Inspection Type: CC7/7'7 <br /> SB180 Posted I t7 ❑Yes ❑ Rermit Posted ❑Yes ❑l Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Com Gs;nI to ft a INrr .i�' .1Chen i j_ b'o 1(o 0 . WC, -sit r iS <br /> r I1 ! G�l I7 C t) r Ct G S e &11 + f d 5 4 � -- <br /> � ! <br /> 1 7 _!! �' GI C r �1�1 c� ' ✓ - f i G t%ll T 1 le - <br /> vrrtl Gf I9 lr ! Occr 114 If ! .s s, i�c' �} ' 'ShwoSi" !. <br /> f C • � � f}GS Sur'n'? e.,1,0 ,� /•� G G�rri� D� 1 <br /> j_ G �a 11 _i'�!t� C U'e� �e�. G_-C ► e a !_�_ <br /> - fac - <br /> ol nth � � ) _ G 1 ir, !e Cl <br /> #tem/LocaUon Temperature Item i location Temperature <br /> Food Safety Certification Facility Hot Wafer Temperature Warewashing <br /> Name: Hand Sink: of Chlorine. ppm Heat: `F <br /> Exp.Date: _ arewashing Sink: of Quat.Amm.: ppm Other: 'F <br /> Received By I Ti e <br /> r2L ` <br /> EH--pecialist: Phone: i -�`(� <br /> Time in: - !10 0 ` 0 Time Out: ��. 7 � Page fof` <br /> r <br /> EHD 16-24(2^ pg) 4013 FOOD PROGRAM OIR CONTINUAT0N <br />