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oPA"'" SAN .10AQUIN Coup. <br /> /1101 <br /> • �QoG <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> . .. �P• Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br /> gc;FORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: -z .07 <br /> Address: City: 7kfi-e� Zip Code: ?,;--S-7/ <br /> (OO <br /> Owner/Operator: lC��lS Telephone: ?N-'6m- <br /> Program Element: / Program Record: s e-d OSS C Inspection Type: PIAW e'*e-TjN,g,L <br /> SB180 Posted---*es--—No Permit Posted —No O Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> A.4 j s s ini& ti W.*" X- el <br /> -�lN?— m2_T_- dc�w�sPl��Tf a4RaLu1� SI¢!tc'E l �if `���l��ck� �` <br /> l�1l►trtD//� <br /> TPU- TrCS W07-hL <br /> Q6cd Pri /S T � <br /> d%epA t7- Wron <br /> - /lb lv �i �NJ s SIc�-N /N RFsr(?m/�is PDS T 20 v� SIGN <br /> KN v.& -- S44" &K-7-79e*rfy l��Z� ��-I- <br /> 7ry <br /> ,s o fic- y 5•Z� -�9 -- _ --- <br /> E. / IAJ 57V T ;,S-Mg-CrOU <br /> Nu P Ap"Cr ,9+v /,9450 C *K44 OWA;4 <br /> 1 H'f <br /> o K Ta /5s 4F 9FRmr'raryC! - 6AC SEESP615 729,,t luTi t SF v R 3 7 <br /> Item/Location Temperature Item/Location Temperature Item LLocatian Temperature. <br /> TRu� PRF� 3 <br /> w - <br /> ................... <br /> Food Safety Certification Facility Hof Water Temperature Warewashing <br /> Name: Hand Sink: �� �F Chlorine: ppm Heat: OF <br /> Exp.Date: arewashing Sink: 1 -37 <br /> J3 /"7 OF Quat.Amm.: ppm at <br /> OF <br /> Received By/Titl <br /> EH Specialist: <br /> Time in: /�f\ Time Out: ; Page t 0 <br /> EHD 16-23 (21d pg)(111106/08 FOOD OIR CONTINUATION <br />