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SAN JOAQUIN COUN <br /> N: X <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: �,`��S �u + ���•" Date: <br /> Address: ` Z City: T2uC, Zip Code: S3 <br /> Owner/Operator: -sal;nR, ,F M��± ae� �� �\�i11`aty�g Telephone: 9�_pz xe <br /> Program Element: Program Record: 5Z�3 ( Inspection Type: ��S <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: rr_D I <br /> MoakOBSERVATION'S AND CORRECTIVE ACTIONS <br /> Iiv1a :) Cpl*AKAz5wcQ�- <br /> ---- s se^ I ce, . hod Im 1"Fila Efl it ,e o,<- <br /> �ib�✓��' kt.S S A r,&4 yr i w Whn t"wd14!* a e r/�- LV1P?4,.,L) 1-1 Z "eA-s <br /> --- ---- - - <br /> ItemlLocationTemperature Item I Location Temperature <br /> I <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: °F Chlorine. Ppm] <br /> pm Heat: F <br /> Exp.Date: arewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/TitleZ <br /> EH Specialist: Phone: <br /> Time in: LSM Time Out: Page of/ <br /> =_HD 1&-24 (211 pg) 41N13 FOOD PROGRAM OIR CONTINUATION <br />