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-:.r��,�+ -W0. •."�^"a.ia.-�......,.:,.,. _y^-"v*7+q*�Kt�+..�.,.., v_:.#F+1 -�q.#`�'�7t�..::,nr. _— ,1�Ugary�,c.v��Ie--._�a. .. ,.. <br /> r <br /> °"'"!y <br /> 0WSAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • c ., ;p. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/e <br /> '9GlFORl� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> Address: 1 F�. city: Zip Code: <br /> Owner/Operator: j^{� `? ; '- - VV i Telephone:641 tA <br /> Program Element: 1 , Program Record: ^^7 �'" � Inspection Type: Cf �i lc i <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: 'n <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> i . <br /> 0A AA Cz6fcA <br /> -; " 1' Y <br /> � - u <br /> 9temlLocationTemperature Item!Location Temperature <br /> )eyo j12 <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> -Name: v. Hand Sink: F Chlorine: Ppm Heat: of <br /> Exp.Date: arewashmg Sink: of Ouat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: 2_ Phone: <br /> Time in: 'I ^� ! Time Out: m Page of <br /> EHD 16-24 (2n°pg) 4/3/13 �A FOOD PROGRAM OIR CONTINUATION <br />