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SAN JOAQUIN COUP <br /> ?� ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: Y A <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �q.. J:a;P• Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sm_ov.org/ehd <br /> L/FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: , C Q � ✓7 MP_�-.N r�'a Date: ��—f&- I `J <br /> Address: 44 0 L W rpt K7'LOfL} City: � Zip Code: <br /> Owner/Operator: V —O 17-a Telephone: L _� <br /> Program Element: i (�a y Program Record: �L& D L Inspection Type: n 0L4IS ✓1.2� <br /> 8180 Posted Yes 7 Permit Posted E Yes ❑ 1 Re-Inspection on or After: ('il + <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 3 r Urn d. ,e lr -t,4-- W ae-k V- <br /> l�-I-e <br /> Item/Location Temperature Item f Location Temperature <br /> Cs00 r C'd C e`� 310 H-O+- clv - - - 137`F <br /> Q�h - - <br /> Q - <br /> Food Safety Certification Facility Hot Water TemperatureWarewashing <br /> Name: Han11 d Sink: I •� ofChlorine: ? 20�ppm Heat: dF <br /> xp.Date: , arewashing Sink: ,) 2 'F uat.Amm.: ppm Other: 'F <br /> a J <br /> Received By/T/ <br /> H Specialis O .w` 4- Phone: OIL _ <br /> Time12 17 <br /> in: 1 , � V 1 Time Out: ,J. 2 G Page?of <br /> J <br /> EHD 16-24(2n1 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />