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SAN JOAQUIN COUNTY <br /> ?j 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 /> �IFORl <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: umlm ovinn <br /> Date: <br /> Address: 4 ( 0`5 C "660 city. S tocp�z n Zip Code: <br /> Owner/Operator: 1-6k "�eCn/�,O R <br /> 16 •, Telephone: <br /> Program Element: 1('000 Program Record: L OU(_) Il()CC) Inspection Type: COM aj11 f- <br /> 8180 Posted 0 Yes 0 Rermit Posted ❑Yes 0 1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> cclt n A� �,rcteA - ( ern oSAS , M.e O tdil Ii '\-f 1 > Gnd <br /> Rout bQP� y lc)oi $eCamz 11\ \4i-Vb },tW0,C rlb vul 'Ith <br /> cantlnW9 <br /> olt7raVEJw >? wt Q ;n (, Un a VVIFIN IdTh 1hQ)- waS <br /> Stiff ar � C�� <br /> Soni N e'I CA+- Cc;or- &VAii m - to - rn LhrdRlr�e <br /> MahA S crrndo S OrR, S-VX2d in fihe _ rT2 <br /> Urrtil <br /> 11 h O SfilirllunS OrC 11 .e &d Sc)Gt 2 wgRM <br /> w P.r -17.w�1 <br /> MAna S S E ee:. \1041✓ n v Sick CA- 11'U�elrec l <br /> 'Ov+5c of Ahe CwNvr\AIn D sk wee-S ord Tme <br /> 60 n& W VrVL n 01hR r -MCA l r li <br /> 'DonOk yri .e U S cm W10`9 CluthhS . wa S .Pc m 2X_ <br /> �tst nl I,Ze,+ co1m Ghl 1?me- c <br /> Stare GO w1 -n Cts bS Tr\ 'Chez- ni h\���e1 when <br /> czar ;" v,5se' <br /> CoRh too S 60 F <br /> eA)Ch <br /> 1CP C t QOti� fU' 1zcG-�;nk; <br /> II <br /> yI _— . ? Shing <br /> Food Safet Certification re rewa.--_.__.,. ____._ _. . I� =F Chlorine: pp�n Heat: of <br /> Exp.Date: shing Sink: 'F Quat.-Amm.: - ppm (Other: F <br /> [eceived By/Title: <br /> Specialist: Phone: nrA ' �� _ 4 W <br /> me in: I;H/\ Time Out: ,/-moi I\�1 -i Page/of <br /> EHD 16-24 (2n0 pg) 4131`113 lJ FOOD PROGRAM OIR CONTINUATION <br />