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SAN JOAQUIN COLIN) � <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �;.. - �;;P• Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> �IFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: rzas ck( C Date: Z <br /> Address: y i e a City: �G1/ . Zip Code: pr g 2Z u <br /> W l� � <br /> Owner/Operator: Xtqr-iC't G�QdQI Telephone: may. -19 g <br /> Program Element: 16 26 Program Record: 0507 W Inspection Type: �0L.-+ <br /> A [ISB180 Posted ces No Permit Posted es El No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTION <br /> � i✓� '� Cti �.� Com. b <br /> li v� r QK f0c rr <br /> a <br /> a, ' I <br /> t <br /> c GQ �4e� <<, <br /> ro k .5f-A-4-t4 fn dal I Spqr4, 1.1-i Cks. Re s <br /> 4Q rVkq o0 a. , <br /> ea^ Q,ti S 4 ( +0 160. <br /> QQ V p \` 0.c[ — 4-p Cmf <br /> a rvk '.SoLes <br /> C.vtvti t' Z.Qr t,, c — 2-0 v/' c U <br /> 2 Q <br /> cc r a rec'_ ° two. — <br /> L <br /> i T n o <br /> {-r Z 4 3q�F <br /> Name: MarlAe-2 Hand Sink: 1 'F Chlorine: ppm Heat: of <br /> Exp.Date: _ arewashing Sink: �S-,r of Quat.Amm.: ppm Other: oF <br /> Received By/Title: <br /> EH Specialist: ! Phone: 4&t <br /> Time in: Z�3C7 Time Out: Z Page if <br /> EHD 16-24 (2n1 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />