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SAN JOAQUIN COU <br /> �O. .CpG 1 <br /> H 'X ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> cq., ip Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sFgov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: h � �r "L T 1 Date: <br /> Address: -2-4-70O Lo ma rL� / ._ City: G� �n Zip Code: <br /> Owner/Operator: arra' �A �--»,� S� v Telephone: "lf 1, _ 1 <br /> 63 <br /> Program Element: (0 00 Program Reco : C00040(oLP Inspection Type/1 �p�;�✓1 <br /> B180 Posted ❑Yes ❑ Rermit Posted ❑Yes ❑i Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> tM n " - -I- J, ' Li o vt �3 I S c►n <br /> Q.S Ser C o` a�r O'F-�{' a4i <br /> le <br /> .c d 6tMa( rAP)+ wa-C) <br /> Lo sn'e_g <br /> s"% _ <br /> Q r i l.%-�, <br /> __ 64 6-e-rvi 60 <br /> " t r` 4 r <br /> ,r c�l,L r <br /> ct \ ✓ L <br /> Item/Location Temperature Stern/Lacat% ,:....... ! ;t >€ wlltKl <br /> Food Safety CertificationFacility Hot Water Temperature Warewashing <br /> Name: <br /> Hand Sink: of Chlorine: ppm ,Heat: of <br /> Exp.Date: arewashing Sink: aF uat.Amm.: ppm lOther: of <br /> Received By/Title: <br /> EH Specialist: �r Phone: f _- t <br /> Time in: O Time Out: ' Page of <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />