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SAN JOAQUIN COUR'' <br /> Z+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> W ..: :< <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sogov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: �, 1�1 tU G Date: <br /> Address: ` G pe &-T--\-1- City: s..;.-,�(x-VCP Zip Code: <br /> Owner/Operator: i Ut-11+ �� I t(� Q� e\� CJqi) _ �Z Telephone: 2_�-�r, <br /> Program Element: IP( _� Program Record:t`Y, z�i T _T Inspection Type: Lam^ n"I <br /> Vffl-80—Posted 10 es ❑ Rermit Posted ❑1 Yes _ Re-Inspection on or After: \ ------- <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> O s' C1 ls�m0KC' X_neA A06 <br /> VN tl <br /> - <br /> ,cke V-,Y- 'Cay-6 <br /> 11 i-i t�I,QS, <br /> - <br /> C6 h 1 CJ(-e4'' 10 0 t)�>m C)\cam n- . <br /> ltemlLocation Temperature Item I Location Temperature <br /> ov - - <br /> i Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink. of Chlorine: I I ppin (Heat: of <br /> Exp. Date: Warewashing Sink: +G of Quat.Amm.. 1 ppm I'Other: of <br /> Received By/Title: I <br /> EH Specialist: Phone: <br /> Time in: 11 .U(` Time Out: Pag of <br /> EHD 16-24 (21�pg) 4'313 FOOD PROGRAM OIR CONTINUATION <br />