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SAN JOAQUIN COUN <br /> Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: Y X <br /> R_ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> .., _ iP• Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.s*gov.org/ehd <br /> RtiFoaa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 3 r� (�>,r,, S s Date: (z/_ -J` <br /> ddress: (rY1'T�Jn City: L. �f� Zip Code: <br /> Owner/Operator: 9vg4l'0h S J Telephone: y l y <br /> Program Element: l V 15 Program Record: P K Inspection Type: u h <br /> SB180 Posted es ❑ Rermit Posted WYes ❑ I Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS �� , <br /> vWrs -f��-s - pyo cr►. b. - <br /> - - s <br /> Q cam. <br /> Item/Location Temperatu Item I Locationi �'3, Temperatures <br /> n <br /> ytp� f- i <br /> met lit n X38 F as .rs <br /> Food Safety Certification Facility Hot Water Temperature�i Warewashintg <br /> Name: �Handink: of Lr�n ppm Heat: F <br /> g of .: ppm Other: of <br /> Exp.Date: ar washin Sink: 1 Z, <br /> Received By/Title: <br /> zz <br /> EH Specialist: Phone: 1 <br /> Time in: O Time Out: Page of <br /> EHD 16-24 (2nd pg) 413/13 FOOD PROGRAM OR CONTINUATION <br />