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PQu�" SAN JOAQUIN COUN. ' <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.so ov.org/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ra ti ` Date: - <br /> Address: City: Zip Code: <br /> 0 0 �ra� 4- �,,.. 7ra( s3uy <br /> Owner/Operator: o I M o r; +�rr3 ` Telephone: 6 S -7Yf. <br /> Program Element: Program Record: 'r Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> �e Je .. 1 $ a 4 d ;s Sera nil A itI-Acied <br /> h.d4 hoH �• �c rr i n I 0feIC. <br /> SA ) i Zer Tw b OiPei r(4nn i f ti .1 <br /> eZ�U i a :n Odiylor Morc or <br /> r W- <br /> S i .•L r, 60 rrf c rY7 rV1 e 0:a l r <br /> ro d u cc S ha S; n K ha,s c+ ACA" � C <br /> I l ; r Is a 0q 4 de �/. jet, G :r ; n / WOO Y <br /> o a y S. COu s h a s d CIO l01 w 02, C In a -►0,1 <br /> u-1 Id' 44 in S e vera, rA r, r 1cr u n �S • (� <br /> }� day <br /> Are Co ✓Pr d 6 Cracked% Re,p I are i e\ 1 woo e <br /> Ice o i ld— i rl roe 2 er u n ."4S• eve i cc ; In <br /> W 0 A K. / <br /> to Id- 4 or ske I vts n I ol a r Q req. G/nAn f Oda <br /> PQ C4 <br /> Item/Location Temperature Item!Location Temperature <br /> — .� .. .. .__.__ ......__—.. _ -__— _ ____�— _..... ------ <br /> Ls <br /> _.___ <br /> 1 C <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: /t4.d-IGS of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: Time Out: z Id a0 Page of <br /> EHD 16-24 (2^a pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />