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SAN JOAQUIN COUNTY <br /> "A ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • cq<<FOR�;P. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: C f rna- Date: 11-to_ly <br /> Address: 119 35 W <br /> V City: ra51 Zip Code: 1 <br /> Owner/Operator: Telephone: <br /> 61 836-2aao <br /> Program Element: l 0 15 Program Record: PA 0 6/9 1'9 Inspection Type: %Zo u�'►we. <br /> SB180 Posted 1IkYes No Permit Posted Yes C No Re-inspection on or After: <br /> OBSERVATIONS AND CORREC I IVEI IF <br /> AC�It3NS <br /> tlz _C0.0 A Lpl yj a ra o k <br /> `fi' 4 Cskw 4- tnSi <br /> Ira we 1 i�-� 00 <br /> v w <br /> 1O&K - C-4'44 <br /> S11 ff1 C - <br /> IN q`k✓ <br /> L5 no'I <br /> o r n d.P ✓ &e )V10 s 60 ve Lo f5 o <br /> Q ,-z cs <br /> ood Safety Certtfica <br /> Name. Hand Sink: of Chlorine: ppm Heat: of <br /> Exp. Date: a Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title' <br /> EH Specialist: ho e: I 'S7 <br /> Time in: ' 0 Time Out: , Pagw)f� <br /> LW <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />