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X, SAN JOAQUIN COU* <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.s*gov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: E, Date: rZ q ,-) <br /> Address: 'O\ ` t City: Zip Code: Q S 2" O <br /> Owner/Operator: C- <br /> -kOC ` -1 R \ Telephone: <br /> Program Element: `b 2 Program Rec 5�� 1 Inspection Type: <br /> 6180 Posted Yes ❑ Permit Posted Yes ❑ I Re-Inspection on or After: WC <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> RCA, <br /> 12- kA � �-1 l <br /> G7A 4--QA sL':g' 01 C"0 <br /> v <br /> cac�lc.2 � <br /> c vZ7l�n q4 - ✓ '19 <br /> WIN. n cko+ 2 (c i - <br /> C©W\ Is 06 eS`�I <br /> 3a_ h. <br /> 'i ,Hot Water Temperature .:- 4g, <br /> Name: C�� and S' OF hi TVA So ppm eat: OF <br /> Exp.Date: _ _ a washing Sink: 1 of uat. mm.: ppm they: OF <br /> Received By/ i . <br /> EH Spe ' 1st: Phone: _O <br /> Time in: ` Time Out: Pageef <br /> E H D 16-24 (211 pg) 4/13113 FOOD PROGRAM OR CONTINUATION <br />