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�aU'" SAN JOAQUIN Cour <br /> ,o. .co <br /> N: X <br /> 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 /> LIFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Sfccy.tM t U nATC 16 Date: 3�23 s- <br /> Address: _22:2 N - k n a1 V City: Zip Code: C( ZU 2- <br /> Owner/Operator: <br /> Owner/Operator: bn al 0RE4nU S I N c— Telephone: TIG 035b <br /> Program Element: (0 U I Program Record: h C' Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> O�- fiU ("nof1roaG <br /> CUT) T\',0 1-'vr ho <br /> —Sj-� Ord OAA+U N u UK-1 UIIGvv e-CA <br /> ItemlLocation Temperature Item/Location Temperature <br /> - _.._..----s_ ------ -- --- -- <br /> Cu I C t- <br /> C Tot <br /> Food Safety Certification Facility Hot water Temperature ( Warewashing <br /> Name: Hand Sink: l °F Chlorine: PPM Heat: `F <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: PPM Other: of <br /> Received By/Titl r— <br /> EH Specialist: Phone: QoO r V�J G� <br /> Time in: I C), C) - -- Time Out: f Q's Page of <br /> EHD 16-24 (2^ pg) 4/3/13 l FOOD PROGRAM OIR CONTINUATION <br />