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SAN JOAQUIN COUP <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sagov.org/ehd <br /> 4GjPo.�� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: com f �v M� �� MqC k-i t Date: 5�Q/I <br /> Address: �-20 s, �` 90TC06 9f City: �t?j r1 Zip Code: q923 <br /> Owner/Operator: lid (D1)6j �7-WnGt<,(o q Telephone: <br /> Program Element: 1[��G1 Program Record: r>fJ (� -4 Inspection Type: <br /> SB180 Posted r.Yes ❑ No Permit Posted _ Yes F No Re-Inspection on or After: 3 V\jWkK <br /> CCN0,,Qi D s a vial 1- m ccd". CW&O Il "JS wi Yh (CkWc, <br /> Vv rzr,, f vi► C/r 1ld s .c Urre'i �03a . <br /> wi j 11 C t S na+ c-�xed 1()O Sark rl elr �PIAC� CO-Vba s <br /> oo fiovT- UTA, on ccmnor s. (crfecfi , cue reed em s1-Fe <br /> 1 e S covy Sir iA,&kcw CQ �,vre, s-f'Te n G s C 1Ctno},1.e <br /> CUh�U'n e-r C0qCC+ <br /> siCae to U I i 'u 11 r� i�\ecAi- pt- cird 0b�Ved cme, Oval <br /> 4--1 �nsicye -zIw meat CV& dC-VTs cw,c-eand �t�e�-i- tic.Int In <br /> es cel , wcmec+ i6tj <br /> PW10CIA dwiS U coves Cion <br /> W 1 i t uv CII) r o f w U 1[� i n Fre c tpan ia�a - <br /> 9' rVo S S-}VP cfi tt--,e f uvr ins WoI Kin free I o1f S <br /> to" 0-f 1Tr.e -f cur , c(.rre_ A- -t-n - - <br /> Item/Location-, Temperature Item t Location Temperature <br /> SAW Mckt <br /> 5_Orin table °F <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: ✓moi `I J Hand Sink: of Chlorine: ppm Heat: — - of <br /> Exp.Date: (�/ I� Warewashing Sink: I3:7- of 07t.Amm.: ppm Other: 'F <br /> Received By/Title: J'o _C\ <br /> EH Specialist: N,_/ Phone: _ ,,9-7 <br /> Time in: --411� Time Out: 3 '1 O Page2of 3 <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />