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SAN JOAQUIN COUNTY <br /> a ENVIRONMENTAL HEALTH DEPARTMENT <br /> N: X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> L <br /> cq.,%F_�`P Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.s'gov.org/ehd <br /> OR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: C1 GYC� Date: - 2-,-J f L <br /> ddress: .31 W eh� City: C � Zip Code: /1 U� <br /> Owner/Operator: cocv, Ord <br /> a-p tur'C A v u CO� Telephone: v1 <br /> Program Element: ��i Program Record: l✓\r7 ( � )CC Inspection Type: �- <br /> 2 V� t� <br /> SB180 Posted Yes ❑ Rermit Posted Cyl(es ❑ I Re-Inspection on or After: <br /> OBSERVATIONS,AND CORRECTIVE ACTIONS <br /> 21CV _ <br /> � �C�ti�fi G1�ef caa <br /> L <br /> ac,.1� nq) r c,�ihS Icy 1 <br /> C y- d cc 1 Wq q Q 1, CG w C-� UC�Ci <br /> 5 I?- df ivw 0 _rb 2 CCAMQoy- CSC'V' 4TF- <br /> pq <br /> QG1 c� � r e l Obi Lam <br /> �tGI llPrt GI - Oro �2 <br /> ?�C�r -"v c�c"�� <br /> oti ��n�Q ... ... ..........__.._.... _ <br /> 4 F <br /> t <br /> Name: CU IOS Hand Sink: 'F Chlorine: 60 ppm Heat: 7"F <br /> Exp.Date: 2 �/ rewashing S' k: �ZU 'F Quat.Amm.: ppm Other: of <br /> Received By/Title: l, <br /> y <br /> EH Specialist: Phone: q f_ iS <br /> Time in: C • Time Out: ..2 PageZof 2 <br /> EHD 16-24 (2nd pg) 4;313 FOOD PROGRAM OIR CONTINUATION <br />