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SAN JOAQUIN COUNTY <br /> ?-+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... `P. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.slgov.org/ehd <br /> Q�,FORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: L�H-L N46t-n cA"c;V\a Date: / <br /> Address: ;�2 b t . *O`U( City: �� -�-� Zip Code: l+�r.� rbc <br /> Owner/Operator: b �v n� Telephone: Q"A-(oL^moo I C) <br /> Program Element: F_ Program rRecord: 01 b 1Cei��. Inspection Type: -(7119?"aj <br /> SB180 Posted ❑Yes ❑ Permit Posted ❑Yes ❑I Re-Inspection on or After: W ee,�f <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> t TW-t are &-i I (� V\ <br /> fe a CAP0 1 <br /> Cn �fi y- in T nuc are� . <br /> -e <br /> ,&e an fckctur maMe, and addresI;, do all uc <br /> 'o-e M-c- . <br /> 3 i(Le o e �cq- <br /> �- 'FOt-"Una `S -ii- VS 00'- an s4e- . u� i <br /> in \ wi?or- <br /> 3 dr IT-V LS C;AM..e, V)&- X �� lanniR <br /> _ UCSLP�f, <br /> fi 11 - W_ qct - �F . <br /> pe erm I Location Temperature <br /> Item7Location Temperature� <br /> Food Safety Certification Facility Hot Water Temperature Warewashing, <br /> �_. T ... ..._ �.pp .. <br /> Name: Hand Sink: Chlorine: Heat: eF <br /> Exp.Date: arewashing Sink: of Quat.Amm.: ppm ,Other: eF <br /> Received By/Title: <br /> EH Specialist: Phone: �G <br /> Time in: : 4 o Time Out: ��C o (J PageVol <br /> EHD 16-24 (2nd pg) 41311''113 FOOD PROGRAM OIR CONTINUATION <br />