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r <br /> SAN JOAQUIN COUN� <br /> :X ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:�t,�oRa ephone:(209) 468-340 Fax:(2019)464-0138 Web. www.sigov.org/ehd <br /> i <br /> FOOD PROGRAM OFFICIAL INSPECTION DEPORT <br /> Name of Facility: <br /> /P7-14Date: <br /> C /r <br /> Address: City: Zip Code: <br /> Owner/Operator: Telepho <br /> Program Element: � Program Record: p� Inspection Type <br /> SBtBt)Posted 4-Ye-s01 lt.�'� <br /> No Permit Posted`Yes No Re-Inspection on or After: <br /> aFSg w p QBSERVT1�.71d [+QRREC7 / A5 � . ... <br /> T. <br /> - I <br /> C� Tic" <br /> _rtecz <br /> - F <br /> - ~" =� fehr►i)acd#iii -v empeaeire � ` _tilaGatioEt ralre:. <br /> ».. <br /> O.9� <br /> `� a ��pd5a`'�fe � �f'��lona--� ..-- " �iii$te� raiui;e �' �T�' b � � ,• , <br /> Name: Hand Sink: 7 7 °F Chlorine: ppm Heat: °F <br /> Exp.Date: / arewashing Sink: of uat.Amm.: ppm Other: of <br /> Received By!Title• <br /> EH Speciaiis Phone: <br /> ime in: Time Out: e Paof f <br /> EHD i&24 (2^ pg) 4013 FOOI)PROGRAM OIR CONTINUATION <br /> l <br />