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oA41=" SAN JOAQUIN COUN', _ <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sigov.org/ehd <br /> Q�;FORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: _ �� Date: q7 3_ t / <br /> Address: 2 L4 1 H61kN,KYY City: /fpRN�� Zip Code: OFZ' <br /> Owner/Operator:ti/7 J r m Telephone: 7(* <br /> Program Element: I Program Record: U I(g(']U4 r _ Inspection Type: '�Nb <br /> SB180 Posted 4 Yes E No Permit Posted Yes ;7 No w Re-Inspection on or After: ^� <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 1.!^ 2EV�0M ol,q pobs ,eP'erc-6 =)e65P'-; <br /> YV1(-Iv5 Rcoell A I C4T CpUE'R "5 M X55 rA)(, INI Egl EwCh'-SF <br /> vv►✓0 61) I(4-Te-L_ <br /> b ON Tb t k 15 Na e r 6- Ro f- 4 , �EP✓� 2 Ta <br /> PIES �Mc�-,LCC40S(iU& <br /> �SLk r J MN'tE� <br /> Item/Location Temperature Item/Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water TemperatureWarewashing <br /> Name: Hand Sink: / of Chlorine: Ppm Heat: F <br /> Exp.Date: Warewashing Sink: 1 of Ouat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: f(' Time Out: (9 J L Page/of/ <br /> EHD 16-24 (2^d pg) 11/2/09 FOOD PROGRAM OIR CONTINUATION <br />