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I <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • .�9 , ,.•�P Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.orglehd <br /> {rr=aRr+ <br /> I <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Frt, 74,f Date: . 12- Ik <br /> Address: � � r � City: j r� ` Zip Code: <br /> Owner/Operator. vwQ je f Telephone: <br /> Program Element: 16 j 3 Pro am Record: SUS 9 S ( Inspection Type: r ; <br /> 8180 Posted V ❑Yes ❑ Per Posted ©Yes ❑ I Re-inspection o <br /> Re-ition on or After: <br /> j i <br /> i <br /> I <br /> as 1/' 1a 4i on,S e YC 00.12 � '. <br /> i pr()VClf 0 4 Der lowe1 diLe P nser a 4 ro h A n I <br /> S '. n1C C:Gvrr 1 ava�al I <br /> 000( Corn4ai r1 _S OA 4he /00 Wee 1 <br /> ro '14C is . nC h#'s a k <br /> �c'r,., Ir �Wrt f. 7'17 ; ,1 jG � e a <br /> b e 1 �.� �l1 f. Gctre < � -v <br /> y rovi de C yl r -�P } S r` ,� 1 WeelC <br /> C <br /> lea ti LA) c IC <br /> 6 5 <br /> 16 C K q C ric,4 jet <br /> n WeeW <br /> I <br /> re -r a in <br />{ ry1Gn Pt� : �iCQ � <br /> i <br /> ` f <br /> _ _.. a... <br /> iISF"ao YllftiFtiiam <br /> Teisa�tttre <br /> Uor We St <br /> --- ---.-.------------ m-- ------=----- ------- <br /> Name: <br /> _--Name: Hand Sink: 'FrQ <br /> ine: ppm Heat: OF <br /> Exp.Date: arewashing Sink: 'F Amm.: ppm Other: 'F <br /> I Received By 1 Titl <br /> EH Specialist: Phone: <br /> ime in: /� O 1 Time Out: i t / Page of/ <br /> EHD 15-24 (2n0 pg) 413113 J FOOD PROGRAM OIR CONTINUATION <br />