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SAN JOAQUIN COU Y <br /> 4 X ENVIRONMENTAL HEALTH DEPARTMENT <br /> - = 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> �1FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: r l5 <br /> --/ Date: -/6 <br /> Address: -143-z <br /> •1 "[ 2 P oL � /'.c /A .� +0�- ��2-0City: S , n Zip Code: -7 <br /> Owner/Operator: , 1 OMq V- Telephone: <br /> �C� Telephone: 6-151?_2,000 <br /> Program Element: I 2 Program Record: P a--0 1(O 0-7 9(-{ Inspection Type: �. h <br /> SB180 Posted (Yes No Permit Posted Yes No Re-Inspection on or After: -2,W1?,t4( <br /> xa. :;.. ,< ,,Y, OBSERVATIONS Atd©CaDRRECTIVE&AG17{7NS <br /> _.,. <br /> --b r 4 iu►-'eb-1fyD,7 o F ho,r,AS,-Ac-_. _ j 4 m6✓-e <br /> a.c cess* h i-<,-, oin-d -lvo d ltia_L't <br /> lCee 1- -&?z 0+ C.ro 5-5 co'-) <br /> � rrc-i n �-i o•-� . <br /> I _ � vru� nen d .. �=o -� <br /> ........................... _ . ...................._ _ a.►._ ...._................_( <br /> 0-0 V rl-.0 Y- ot 01 ►'tom 7� "' f �' X1 ._5.... ._ ►r <br /> A- L <br /> 4M W U' h + C0 V--e r h -- a-It r -R-,F mo V-f- c4-4e <br /> 6-t i-r rt 6-i n 4 i 0 Y©h 1-ez CS - <br /> o ot V y, cc-eA 5 'Lr-, Uj Ck-.t11C-i kj P, <br /> M v--2 CI Z hI� <br /> I <br /> or'A 0,4 b Ub o <br /> __........no__+__ ___w r_ -+..►Z�_.__. . c� a - b. ►bd ................. <br /> --�_. <br /> (.i h+ Y-)r cle 55 a r <br /> : ....J rY1...... r �e - <br /> __....__. _G' _ ' c ._ ....._.._..b :ice.... ----.ka� _._c a ILe�( O r� rYw G cl <br /> rn oQ12 n e�I a r-o, d.o LA-7) n (fit p La cA- &f <br /> r ae--I-a k r 4:A ri-e CLU3 CA-j of V-7 <br /> V-o r4 _ w s o) P1.0i a s +�l Y-L-1 of Y e \)-e r <br /> U Yl °PI ►1.i_-� r_ _--1 YY► (7 v�Q_ C� of n Y1'� <br /> L8 o r? <br /> rou" i rue__ a i s , -- rrp-�+ 6 �S <br /> „� w . ItemlLncation emperatureY t item I.Locat,on `Temperature <br /> r <br /> WeAYYI jL t.e 10,q+in S , <br /> Ackawe r H V3 -----------_ ct <br /> i -ed v r 1-75 <br /> 9D . er- rt,f�r. �On � crtyio VYater ;e rature Vllrewashmg �� ... <br /> Name: ynt�LM.� Hand Sink: 1/00 'F Chlorine: PPM I <br /> Heat: - aF <br /> Exp.Date: I 1 ew in Sink: 12-0 of at. m ,0O ppm Other: of <br /> Received By/Title: ` � � - — <br /> EH Specialist: Phone: �$ ) <br /> Time in: Time Out: 10: Page of 2 <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br /> Q Fnod YnQkLa5e r and -, 6o lit)ial-er t-ca .-ds V,, f'i r.e.j e rK k,,- <br /> niAwxjtr b,) too cl.*,ys oft cwt►-dam 1c) 30 CA-P* S. . <br />