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SAN JOAQUIN COUNTY <br /> �.••��••.off <br /> 2 z ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> c�.• - �P Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> �/FO•Ra <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: MUfp JFGSU MOI�-e t Date: v /� <br /> Address: 1!l M C>j>� (-"O � City: S+,', �jll Zip Code: <br /> 1 v � - 2 � <br /> Owner/Operator: SC�n u� Telephone: <br /> Program Element: Program Record: 0030 4 i G]�-,> Inspection Type: CG\MIMA'k 0 fi <br /> SB180 Posted ❑Yes ❑ Rermit Posted ❑Yes ❑I Re-Inspection on or After: <br /> ck.aCl G 6k •} c 00L-VU ac G hw e �b C �, - CCV k- <br /> Sln� <br /> Last Cj-TNyi .Q. NN0,(> Ln LDZk G/I\0 - �-QC.aq+ <br /> f W CSS o C)t 00 01Y OW)t cA TRCMS,W M <br /> 4he, hat, veu yF to � yc e bin . ��nP�r Sfi s <br /> MC�i n�-a� e + (s�firol Orld d_\ o�) <br /> Name Hand Sink: of <br /> 7ChloriAne ppm Heat: of <br /> Exp.Date: arewashing Sink: of m.: ppm Other: °F <br /> Received By/Title: / <br /> � v <br /> EH Specialist: Phone: Ory_ {„G, _ 3 44(,::, <br /> T.ime in: F7 ; C,�i Time Out: '1 ;ZC Page of� <br /> EHD 16-24 (2n pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />