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SAN JOAQUIN COUNTY <br /> z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �q.. a;P• Telephone: (209) 468-3420 Fax:(209) 464-0138 Web:www.sipov.org/ehd <br /> �IFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 5�Gi NIi �- Date: <br /> Address: ev'3�Ct t 2(o City: S CA^rLM Zip Code: C�S-2 <br /> Owner/Operator: Tt)U Cin x G Telephone: 'B ^ ca <br /> Program Element: i�Ol .3r- Pro ram Record:d (d a2� Inspection Type: <br /> S131 80 Posted Yes 7 No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 1� vi&kl jcmG_u"e6+(5 1 <br /> Item/Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: 'F Chlorine: ppm Heat: 'F <br /> Exp.Date: Warewashing Sink: ` - F Quat.Amm.: ppm Other: of <br /> Received By/Title: 19 <br /> EH Specialist: Phone: <br /> Time in: �I Time Out: 1� !\ 1 Page( of <br /> EHD 16-24 (2nd pg) 4/3/13 V FOOD PROGRAM OIR CONTINUATION <br />