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SAN JOAQUIN COUNT' <br /> ..? <br /> z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.orq/ehd <br /> �iFoaa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Q wee Gj'- -7 Z3 Date: <br /> Address: 3 1 3 l�vt�'i'l ef^ n City: / G Zip Code: 9S ZOO <br /> Owner/Operator: 1 G C '"� Telephone: <br /> Program Element: 1(./5- Program Record: 1�5 / Inspection Type: <br /> SB180 Posted es No Permit Posted >qes No Re-Inspection on or After: <br /> Item/Location Temperature Item/Location Temperature <br /> -- --- - - - <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: + o o .'- -F Chlorine: ppm Heat: F <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Tit e: <br /> EH Specialist: Phone: <br /> Time in: U Time Out: Page f <br /> EHD 16-24 (2°"pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />