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SAN JOAQUIN COU. . f <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> *ti bad;a Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: j -75T7 777. lqgZ� 75 Date: 2 /'� <br /> Address: D City: Ip Code: S 010 G <br /> Owner/Operator: T lel one: _ &,3(5 <br /> Program Eleme : / Program Record: I specti Type: Y/ <br /> 8180 Posted NX!!_P o Permit Posted D Yes ❑No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> e <br /> O <br /> i <br /> b <br /> ItemlLocation Temperature Item I Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: /00 f .FChlorine: PPM eat: <F <br /> Exp.Date: arewashing Sink: /'Lc y eF uat.Amm.: PPM ther: oP <br /> Received By/Titie: OO�� <br /> EH Specialist: �\.1 Phone: J 1 ,//b O330 <br /> Time in: " ` -7r7� of <br /> Time Out: `Y� // Page <br /> EHD*24 IN°pg) WWI) FOOD PROGRAM OR CONTINUATION <br />