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SAN JOAQUIN COW <br /> ?� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sagov.orp/ehd <br /> �/FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: bob.,S Gt rJ-Lle Date: �-2 v <br /> Address: ?sq 1 L" S4 City: C Zip Code: 9 S <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: 11 <br /> SB180 Posted /Yes No Permit Posted VYes No Re-Inspection on or After: <br /> reOBSERVATIONS AND CORRECTIVE ACTIONS <br /> :1 ' � C luc '.,\ Dull - SII, ( leti.� 4cd-vResIf-,c,A' q u e �'.'el s: II Close.Ce i s broiler. (it Oc r 6df I aid <br /> fe uir Se I( C loser vh testr000rt door. CCrrecJ a .I Weels <br /> Item/Location Temperature Item/Location Temperature <br /> t Ly <br /> 1 1, <br /> Food Safety Certification Facility Hot Water Temperature T Warewashing <br /> Name: V r Sink: of Chlorine: ppm Heat: F <br /> FT-1i l/-.•� /I L <br /> Exp.Date: arewashing Sink: of Quat. Am ppm Other: of <br /> Received By/Title: ©CJ 11 <br /> EH Specialist: Phone: f/ <br /> Time in: / Q Time Out: Page of <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />