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SAN JOAQUIN COUNTY <br /> Q` ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95206-6232 <br /> Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.smciov.org/ehd <br /> �fFO1�a <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: hArlIKA <br /> Date: <br /> Address: <br /> 7S a f City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: L, Z Program Record: Ile-7 Inspection Type: ,, <br /> IS 5180 Posted Yes f+ No Permit Posted Yes No I Re-Inspection on or After: <br /> AIDO�!R1'�C ! <br /> '-_ <br /> /2- 10 _ <br /> 1Erxt1 trod ?:era <br /> stt- r fic tk> Fad #01 ff ter Tett C re, "! it drew"un <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: of Quat.Amm.: ppm r <br /> ther: of <br /> Received By 1 Title: 7 <br /> EH Specialist: Phone: <br /> ime in: , Time Out: �^ 3� Page Py <br /> EHD 16-24 (2n°pg) 413113 FOOD PROGRAM 00 CONTINUATION <br />