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------------- <br /> SAN JOAQUIN COUNT'S <br /> ?, 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 /> c,Fon <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Date: <br /> Name of Facility: I <br /> I City: � Zip Code: q S ZQ <br /> ddress: 1 c OO V\ L� <br /> J Telephone: Y1 _ --R b-7 <br /> caner/Operator: �\� l MQ� (� CJ <br /> Program Element: \l_ CO P ogram Record: � Inspection Type: <br /> 6780 Posted `El Yes ❑ Hermit Posted Yes D I Re-Inspection on or After: <br /> L <br /> b � <br /> Pvi <br /> FSC ' n4);3 <br /> r,p <br /> . and Sink: "F hlorine: PPm eat: 'FDate: 7 rewashing Sink: \.L -F uat.Amm.: PPM her: "F <br /> SP <br /> eceived By I Title: <br /> H Specialist: Phone: b _ O <br /> ime in: G . Time Out: <br /> Out: Iq Page.Zof <br /> 21 <br /> EHD 1624 (2m pg) 14/3/13 FOOD PROGRAM OIR CONTINUATION <br /> W d „ <br />