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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �.. iP Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> A��FORN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 7/7 G Date: 76e - , <br /> Address: vn City: n kj Zip Code: <br /> Owner/Op rator: - V v Telephone: <br /> Program Element: /, Program Record: r ` Inspection Type: r� <br /> SB180 Posted ❑Yes l❑X No Permit Posted ❑Yes ❑ No a Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> u <br /> (10 0 ak i-7 hr,eiak dh 13l F, a WP /20< akid �6� <br /> F. n- vvt �•-�t �� /3f <br /> t -�_ <br /> b1-f w 1-C A;k_,-- 9 e_6 k V aAJ- 0ti OkP (el' qILa c!� <br /> 3atw�/ , 0 Kv Y weu /V7j ,� , <br /> �✓Vvu;ww"C;2�� t,( f �cls��t� � 3 h-e� ,(d" �� ��� <br /> ( filvtol UMC to <br /> V Iv V AA --t v, <br /> 4Wrn ". _� -2-4 <br /> OLPF <br /> �pvz vwr�rrv- �G` �► lI <br /> Item/Loct9rW;,'�:ge n perature Item/ cation Temperature Item/Location Temperature <br /> CA aGt l3 'f' Qe.' e F <br /> Food Safidy Certification Facility.Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title. <br /> EH Specialist: ho e: Ly <br /> --GJ <br /> Z� ` <br /> Time in: Time Out: Pagerf(, <br /> EHD 16-24 (2"d pg) 419/12 FOOD PROGRAM OR CONTINUATION <br />