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SAN JOAQUIN COUN i f <br /> Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • o <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sm g v.org/ehd <br /> .. <br /> 4�ii Obw <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: e/rCuj() CGIT 1 U Date: -7/.4/14 <br /> Address: 3 01 q S. t 1 busad 0 City. 51MC1k1_fivT1 Zip Code: <br /> Owner/Operator: r1 L_..,` �} Clow--,), <br /> low Telephone: Cl"I 2-3 <br /> Program Element: I b jCj <br /> Program Record: P R bC" Inspection Type: t 1'Ln <br /> r <br /> SB180 Posted Yes 11No Permit Posted Vyles ❑ No Re-inspection on or After: \N X9 � <br /> _* G <br /> Yru <br /> M19a i-. CLS Wo c e sI . <br /> de, chl stri S r t1 Q <br /> SI i ud pmckltoS not or ? can l T via <br /> Cly- r5aT. . PtO N y SA -Iv 41 F ur bel our 1-6 Gla <br /> o�se J24 IM P - ua ccacnrJP an 'WGQ . <br /> +� �1 1 Pediah �o da <br /> t NG{- Il �- 06Me .e tr tw wa 'n udtlu . Cwex a <br /> W,\ IuS�i ur7 . tdl 1 I Cir <br /> & lut A%w Lt on ihe, kluoy- in tree e <br /> �dat <br /> S s are, fe O cn -tom cwe cii1 <br /> ivo s o 4 fire p-cm rd <br /> Ob ah I e2 w (.h hand <br /> \N\ ock an h ord wa5b Sr . <br /> Nu SOct A- thk +ar& a (n�-. v 69- W15isli . <br /> (Io Col 6 '�aAeA barICAL a is S1 mc- I�\SSi <br /> vQ -. <br /> It s4e M �- h I Xff GI- Izb� � �iCi� �o� -tlo"F s_"y'We <br /> N wi-r> a iZ Carne o5 a da rwas Mehl S . poas t q 1t <br /> Iv 1 C r <br /> fe <br /> (A W 1A eO <br /> W CoL - - [ Wca f s o s- am ttW 102-1)o or- <br /> \N <br /> 1N 1Y_ krn M eAt we t� J I V nQ. a Sada OfihK t2o 00 eCts <br /> Name: Hand Sink: 100 <br /> of Chlorine: 0 ppm Heat: OF <br /> Exp. Date: arewashing Sink: 2- 1 �F Quat.Amm.: ppm Other: of <br /> Received By/Title: V <br /> EH Specialist: Phone: -)—O (o <br /> Time in: j LFTime Out: I r Pag€2of <br /> EHD 16-24(2nd pg) 4/3113 FOOD PROGRAM OR CONTINUATION <br />