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�°PQ <br /> '. `"• SAN JOAQUIN COUNTY <br /> Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: CelDate: <br /> ddress: 3 51q �' { ti Zip Code: <br /> Owner/Operator: le C .�` Telephone: <br /> Program Element: I V w Program Record: C 3 e 7 Inspection Type�i� ai(`. <br /> SB180 Posted V Ll Yes 7- PermitPosted ❑Yes ❑1 I Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> GL m, n <br /> yu 00 <br /> OlA,�_ (/ <br /> .� f <br /> i - diA,14r <br /> i -- <br /> /11'�. t <br /> Yet <br /> .. <br /> 0w <br /> ` (%r, <br /> M-4 VM <br /> --,-v►� .�vvi�vvvv� CGtiAjl <br /> Temperatures Item/Location Temperature ' <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Vhlrine: ppmHeat: `F <br /> Exp.Date: arewashing Sink: 'F . Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: I I ITime Out: Pag o <br /> EHD 16-24 (2^d pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br /> a <br />