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"q"!" SAN JOAQUIN COON' <br /> X ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sogov.org/ehd <br /> L/PORN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: fr %' ` t l- Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: cJ OP <br /> Mt kTi tk1a Telephone: <br /> Program Element: Program Record:: S� / /ap Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No J 7l Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> tr 7c <br /> Na, <br /> i( <br /> ion, LzQz in <br /> Item/Location Temperature Item/Location Temperature <br /> �_/ //_ k i /�44L <br /> J 09 -.f i jAAL <br /> uV Y4- l _ ' r - - 37 <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: °F <br /> Exp.Date: Warewashing Sink: j' 'F Ouat.Amm.: ppm Other: 'F <br /> Received By/Title: <br /> EH Specialist: ( Phone: <br /> Time in: I 7 Time Out: / Page f <br /> 1 <br /> EHD 16-24 (2n,pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />