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SAN JOAQUI,N COUNTY <br /> ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> I <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> 411 Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/�ehd <br /> k <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of FacilityN Date: 7�� /b <br /> Address: 1005- e pe so e" O City. /"n C Zip Code: 17 Telephone: <br /> Owner/Operator: Gr f-Pe-1 r II Telephone: /��1 <br /> Program Element: a Program.Record: S !) G 3 S Inspection Type: r G <br /> B180 Posted E Yes E Permit Posted E Yes ❑1 Re-Inspection on or After: 1 <br /> E <br /> �..a 1-0 e-.a... r� c r- 1 cot n v; i rc 14 <br /> Gda Gx e's' C nC� r n <br /> S I � � 4he bg c, Ccrfecj i -1 <br /> V)eeK <br /> 3 C'- n • Gc; 1; ., a6 Ve rep ar7a &4- <br /> cc,/Y) <br /> eCa/Y) 4 ba, h as hQ,0 'f 00, <br /> �re 0a 1% -1WN Ur' S x N b 12 - <br /> r G U d� r0 4 er �, 4rc h, ; � O al� <br />`k b ra a IPar 0 ArZ IPS IF SC? cc <br /> i'S� rpa GG /rPCa ;n I.JPa 1( <br /> rove l�Cr I�JGrr� Jrr In Sc� Ccn rpSAroc, 4&01'1 <br /> JVD uy Shy n rnt Or 41\AWi� 0�: <br /> } r; AK n <br /> 1i- ns Leci�"6 <br /> 4e01re ro O'.rnd 40 be 3e 4 <br /> S;rKin .CP <br /> 0,K. Ad IF r- ohfe' �P5 havers �7nan a � 7�A.A�10 �'_ o2yP � u 3l d' G <br /> & T ort CC&A 4e r <br /> F0Ci1; hef5 - I +{'IFoAr Silly -,—C' I fn )C-44ty^ 61^d I h0^61 J .3-Com S� ve,4 kur <br /> g[s4rooels 14CKr' GG11r? D+ � �SC� fc�tnj blPa Es <br /> 0u1n Clive d 4,' Iej u): )/ b rn A ; l-e-, 1S0 ,),q <br /> �a <br /> s. <br /> ..a ._, -- =o � nra ire: <br /> fn r 3- AI v ,u <br /> ------------- <br /> ---------- -------------------------- ----------- <br /> .s <br /> f Name: rar!ewashing <br /> nk: //0 of Chlorine: ppm Heat: of <br /> Exp.Date: Sink: Z 'F uat.Amm.: ppm Other: OF <br /> Received By!Title: <br /> EH specialist- Phone: 3/ <br /> ime in: y S Time Out: �,�� LPageof <br /> EHD 16-24 (2nd pg)14013 FOOD PROGRAM 01 CONTINUATION <br /> U <br /> l��� Twjr7_m k le'6S- �5::� 6 PIA S <br />