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rn► K r.?- <br /> SAN JOAQUIN COUt I _5 0 k' <br /> N ENVIRONMENTAL HEALTH DEPARTMENT GQ�� <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c..; - �P• Telephone: (209) 468-3420 Fax: (209)464-0138 Web:\wm.sjgov.org/ehd <br /> QC/FORA <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: !eJ c-K-toy, Or+s Date: 14 -10 -15 <br /> Address: 40 y W T:7r'p r>20.- + + City: C 1 _ Zip Code: q 5 <br /> f1. , <br /> Owner/Operator: a . n ��v� Telephone: /G(4 LI-) <br /> q 1 0 <br /> Program Element: r to D0 Program Record: Co 3C3 y 5 0 Inspection Type: c_(J ta�+ <br /> SB180 Posted Yes [IPermit Posted Yes ❑I Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> I ✓ <br /> C0 Yi ca-ss i o n n c�.5 `T w i l-o o vi v 3 c1 a s <br /> r' tl i ; `Thi re, rt usi -�'oocl a <br /> O 1.� Ke Gh► -�rn YYt ex._k-i <br /> Am aLA. mon ce 5S i o).1 54-dy n <br /> I--<- <br /> VLP r <br /> Ot"�;6-..1.S rYt.L co n 245 I d vl 64 A ridA Ii-q.V_e_ <br /> r too rS A Y2 'R - <br /> C4 tom/ <br /> ItemlLocationTemperature , � Item Temperature <br /> Food Safety ce ificafion Facil"sty Hot Water Temperature Warewashing ]'F Name: Hand Sink: of hlorine: ppmHeat Exp.Date: arewashing Sink: of uat.Amm. ppm <br /> Received By I Title: i <br /> H Specialist: aM` _ l_ Phone: <br /> Time in: 5-30 <br /> 0 Time Out: I✓.q 5 Page, of <br /> EHD 16-24 (2n°pg) 4/31713 O FOOD PROGRAM OR CONTINUATION <br />