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'a�,qutiv.•c <br /> SAN JOAQUIN COUNTY <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 ov.or lehd <br /> �%ROAN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: U 1 : i N ry <br /> ddress: ��11 �,�y Date: W212 /16 <br /> - <br /> 2 M a R,lF Ln City: S (.�i v t_` Zip Code: <br /> OwnerlOperator: "�` i 1 N � <br /> Telephone: <br /> Program Element: 5 �� Program Record; <br /> l Inspection Type:C G I n'� <br /> SB180 Posted ❑Yes ❑ Kermit Posted ❑Yes ❑E <br /> Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> CSM Ft G-InA- ficx h�•r-� GHQ 2 dl S i n `(h-e MUS fi <br /> -�- �t� . M G nCt o -�;r P i o c n e X to <br /> 12 led 2 duS in The rnun Nle n'k- Obi c <br /> �. a- <br /> c e an I-W- 1 e.e <br /> tsre- 6c>rAcC50 <br /> __. Clr q)\1,W01-,1 i n A VI <br /> ItemILocation Temperature ttem I Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name, Hand Sink: -F Chlorine: ppm Heat: `F <br /> Exp.Date: arewashing Sink: of Quat.Amm.: ppm Other: `F <br /> Received By I Title: <br /> EH Specialist: Phone: {2_ - 0 <br /> ime in: Time Out: �`'1�� �C�YJ Page {of <br /> FHD 16-24 {21d pg} 4131113 FOOD PROGRAM OIR CONTINUATION <br />