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PQAI" SAN JOAOUIN COUN' <br /> 'o.��.coc <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sqqov.orCj/ehd <br /> L/a=oR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 7377777 Date: -- <br /> Address: yS`W Lj Lti, { �- City: ; Zip Code: <br /> Owner/Operator: fa3n Ck ( ��t 1 ( S Telephone: !' <br /> Program Element: r Program Record: Qr6Q Inspection Type: i <br /> SB180 Posted es No Permit Posted iYes) No Re-Inspection on or After: <br /> fJBSERVATIOWSAND CORRECTIVE-ACTIONS -� <br /> _..._............. ___...._.__..-._... _---___._-F. <br /> 1 �Q�py1' kac;� S¢R--CttX« k - �i f "'I Z v)eaS. --- — <br /> 2 1Aab fhI Ae,-1 NZGP. C IeeO�O <br /> A 5 r, ea -bY* (� �0cc�h� C btl& 'ire fw� k, <br /> ti h. g `r --- aWu. can tat( cEtd�ctwt wvt (11 C. <br /> fS '�Q,�C �, �C�, 5•{ � trc2 t� rn� , <br /> 0*ei X A e%,A d s et(Qa. CoAmAeAm 6& evoi led Awls. ,i <br /> b5e+hrzd Ude de thdowi amt VSQ- a ff'A l�' <br /> '7-,'= <br /> cad f7 jemperature Rem/Location temperature <br /> u. <br /> l Z• r <br /> Food Safe +{ert'sficaGan of Water i etr�pera Warewash mg <br /> Name: Hand Sink: -i -F f ine Neat: -F <br /> Lr l k,�"-..�:.�I'�,t= �/-: ppm -- <br /> Exp.Date: 1^t i!) , 1 arewashing Sink: -F Quat.Amm.: ppm Other: -F <br /> t <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> — �t -- <br /> Time in: t ' . Time Out: 3 r-- Page201205- <br /> EHD 16-24 (2^ pg) 4/3113 FOOD PROGRAM OR CONTINUATION <br />