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*F:O <br /> SAN JOAQUIN COU�Y <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.saov.orq/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 0.K 2 r Date: _ Q <br /> Address: L C /1 City: f� f�� Zip Code:5 ,60 ,9 K--i � <br /> �O <br /> Owner/Operator: - {r I Q 7-rt-45n_ Q nc� Telephone: _ 7 <br /> Program Element: 11.0 ZL� Program Record: PIZ0 5& 2.70-I (o Inspection Type: 2orl-j, <br /> SB180 Posted Yes d.No Permit Posted 1-Yes No Re-Inspection on or After: �� <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> HCA Y1 JW-aS h S+M-41 ekua I. rev wu <br /> moors d011.1-1 <br /> W � <br /> c ; b 1-e <br /> L-1 ' n Coo C2 r lScQ rd 6XILC ccelfzn - <br /> yh;r at c4 Len rrLc(A,�of 4-2 <br /> �TOLl,( CA r Vyu.-f0a ives iAl LAJ a.UCA'h colo 4 r <br /> b oZ-W <br /> wLe.1 s r�•c-fo u.-1-. t5 n.,i � -�; ar.vu,;Cah Cv. <br /> 62 0 CLZ 10 U_c4ct4 o m <br /> WO P16 4i o <br /> -1-�R w ia-c.:K.S cL - C a ACC a wee r)�:_ -fel-►ani hav-e- <br /> v r.t� vie, h der 6A-; <br /> IterdLocation Temperature Item/Location Temperature <br /> ---._......- —.-.......... <br /> 12 La 3� <br /> LIOCIC <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> ------- ------- — ---__._---___._----- <br /> Name: VIU �.ni la Hand Sink: - of Chlorine: — ppm Heat: F <br /> Exp.Da l/r�� _ 1✓�/ Warewashing Sink: �F Ouat. Amm.: ppm Other: 'F <br /> Received By/Title: Y 1 <br /> EH Specialist: r_ _ n 1 _ �, I- Phone: C1 5 3_ 1-� <br /> Time in: /0"(/0 �'�'1 Time Out: I IX•_a15 Page,,,o_f <br /> EHD 16-24 (2n'pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />