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C' SAN JOAQUIN COUNTY <br /> ?, ENVIRONMENTAL HEALTH DEPARTMENT <br /> r _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.s qov.oMLthd <br /> 4Lii�oRa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: <br /> or, " 5 r r; II <br /> ddress: A 41 h: ►Le a City: Zip Code: <br /> Owner/operator: Telephone: <br /> Program Element: Program Record: Inspection Type: du 4'&0'\C <br /> IS 8180 Posted ❑Yes Ll permit Posted ❑Yes C I Re-Inspection on or After. <br /> A - . <br /> !� Z r P �5' S +ora <br /> ions 4he ArGan1�!_ _ - rTG :✓1 �a , r1- Or1Sc,as <br /> o �c <br /> ora�; d 4 �a�P Is - ►n �' r1.s P r &T : n 111. G he <br /> qnd G Vie- r �arrec -_j <br /> - 1C e b o ve r�u — -P� �_.�►n <br /> 1�e10 r_. S orr ►'�,J 1.L. G K�t1 be /Ow <br /> fr1ra/,21 re a A. r c 1 k dA <br /> ttcl 7 <br /> �tE.( ra.dcor� rp�A -e tl <br /> a0,94,,,�.I <br /> s"zzos! a�lit€p� �rT �pi�� ns <br /> YYrsruuahing. <br /> Name: <br /> Yo h c S Mg Hand Sink: �� �F hlorine: ppm Heat: aF <br /> Exp.Date: Wrewashing Sink: of Qua" : ppm Amm. Other: `F <br /> Received By 1 Title: , <br /> EH Specialist: Phone: <br /> _ Time Out: Page of <br /> rime in: ;2 <br /> EHD 16-24 (2' pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />