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i <br /> SAN JOAQUIN COUNTY <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.orglehd <br /> 4LjFORe► . <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Rate: 7 ��' <br /> Address: City: Zip Code: <br /> Owner/Operator: .2 /l Telephone: <br /> Program Element: O Progra Record:1 0 Inspect ipe:_t - L <br /> B1$0 Posted ©Yes LiRermit Posted ❑Yes ❑I Re-Inspection 6n or After: <br /> f <br /> EA <br /> a GG CAA t V <br /> { <br /> j <br /> E _ <br /> i <br /> Vwk Ck�_L <br /> f Y1�FNu1 > av,di�vY G = /a S i� r �n(lti�G f <br /> �..Je <br /> : ......�.�mm m- �.• <br /> IR ME <br /> Uh co7,rr c 3 S l-f 76� <br /> dal <br /> ��d �►� F <br /> Iser <br /> Name: Hand Sink: ofhlorine: ppm Heat: 'F <br /> Exp.Date: Warewashing Sink: f uat.Amm.: ppm Other; of <br /> Received By 1 Titley <br /> EH Specialist: Phone: <br /> ime in: + Time Out: ce �I vv Page of <br /> EHO 16-24 (21 pg) 4/3113 F000 PROGRAM OIR CONTINUATION <br />