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SAN JOAQUIN COUN• <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • cq.. �P• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.segov.org/ehd <br /> �lFORN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: is I ri ✓ �` VC r ` — Date: C j <br /> Address: ( ; 1 ,1 C h I IL City: , � l Zip Code: <br /> Owner/Operator: W C• 7 dl Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted Yes _ No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> ii e. � t� : e1 r• ,r ; <br /> V ern a n d C ; n (4 o le _10 VI <br /> lao r. G n re A f)N vs <br /> GS h h G n J5 Q Vie r 46U rA., n q /0 i i io roj Un •`c <br /> U <br /> 1'e a a r _P ,J l iMale6l.allv <br /> r) K. P r ; c% G 1 n C h A ; c A0 i n l ,° <br /> ReS ) roo,,ri S Aa a //V so S ; n ti <br /> of ; nal i 4? ks . <br /> y r V LO'lr i n Pa ir ., 1 . � y Lo hCw a hooel lea Move <br /> U ndblain qIfyer 4hal i5 a rovo d, CorrecI 1aal . <br /> t on i ; eS; a lin h ra,"ev 1h , .� <br /> 'AI o od a a j ise J Q A Ile r'e< ?W Cc, r ro c$ <br /> i m nye d; ca 4/ <br /> Grp: l r ; ele O-C Shed 02x l90 Seed airAt <br /> I We <br /> i 4h 04'.,M Or Cc crearyl <br /> f'ray, Z ePernove /. <br /> Gdr, v . _ <br /> GS SLOG _;flora e G rCo. Pro V; de $ Gc S <br /> P\ h 'd/les <br /> Item/Location Temperature Item/Location Temperature Item/Location Temperature <br /> Cold ie( /P ' 1�C 1 I (��� 41 <br /> Food Safety Certification Facility Hot Water Temperature Warewashjng , <br /> _ <br /> Name: Hand Sink: °F Chlorine: ppm Heat: OF <br /> Exp.Date: Warewashing Sink: °F Ouat.Amm.: ppm Other: of <br /> Received By/Title: <br /> i , <br /> EH Specialist: r; Phone: f 16r <br /> Time in: l '170 Time Out: Page of <br /> EHD 16-24 (2nd pg) 4/9/12 FOOD PROGRAM OIR CONTINUATION <br />