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SAN JOAQUIN COUN' <br /> y� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.slQov.orq/ehd <br /> LlFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: G Q 2 Date: 7 r ^r <br /> Address: / LJ . City: Zip Code: <br /> Owner/Operator: / �a 1 _ 00/1 r. 4- Telephone: <br /> Program Element: / 2_ <br /> �5— Program Record: C)S- Inspection Type: <br /> SB180 Posted Yes! No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> �h� (U �C� ala ' c:J y .. S t�✓1 QT' Q � C��' C1r^Q. ri.L, { <br /> Co V e Q<< <br /> /� <br /> ^ to e e r n S+rt&ckt A rlo 4o w a-/L t'�. n fct F -.)I -G <br /> A 'Kw (re_S t,� o ve f ` Q . Ike- d o'v-t- <br /> I."I'A&ow ✓lo C c C o V!e✓- + O"R (r <br /> �`S SQ C las5er 4n� �vtc <br /> -Ger- 41_­��'_tr tf <br /> ���tie cock e h c 5 rcwi�st sq,� ' Z,v� 50 l fk <br /> too rn or 2c)Kz1 uo- wevj nor-k11"� <br /> Y 'T4-Q— ���dQ� ov f�r- -e Q"+0 5 ►'hoO"w1{'_J I`S 4i <br /> � N O e v.�er2 �ed tit of o�..1d.s �tZ,rnk <br /> -f <br /> S ►^ . F-k--' ( rn,cer �' 1N k i r � .•.1 S �^�e�t/ _�Cwr I h <br /> ' & Se t -LiLj (r1) r� f'rciU �c •n <br /> Lid ,475 5Kec2_t ,) 4Ur &2+-v-- <br /> L k-I 64 -(f W 2e r- VA k as a. <br /> c:�, c� 0.t r' '�"'� P'f�(/ "�" �c� �i• 1 — � c�cc � . <br /> 1:757F <br /> Item/t.ocation` Temperature Item/location Temperature <br /> Fr-w,4- 3 S u X&C-C��e <br /> Fro 1-- co u cA-(er 3-70 0 r V e T k r t.> or ' <br /> nname- cream rv'�yt 3��� or_'i ve •Thr Z Door <br /> �rC� �'V�AC A P 5 +mow ) ��v 7'-{ ICI 21!��,�C•�- �J <br /> Food Safety Ceirtificaiion Facility Hot Water Temperature Warewashing <br /> Name: 55, C4 Hand Sink: ( o d 'F Chlorine: PPM Heat: oF <br /> Exp.Date: _ arewashing Sink: 1 ` �F Ouat.Amm.: 11cx-.J—i„PM Other: 'F <br /> o f <br /> Received By/Title: <br /> EH Specialist: . 1 Phone: A4('Cb — [SL/C;- <br /> - <br /> Time in: r Time Out: r oma;- PageZof2 <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />