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SAN JOAQUIN COUNTY <br /> .Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ..: �P• Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.s'gov.org/ehd <br /> 'a(IFORt� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: L RL I N -Q. �� C�) Date: 12 16 <br /> Address: '�j�(0 U wM 0-1 1ASCA <br /> City: &trlcloup-1 Zip Code: cj <br /> Owner/Operator: 0J i RQS L-6 L Telephone: Gt+(o _ l loo <br /> Program Element: f _jK Program Record: D Irk S b ` G1� Inspection Type: T-�, -b <br /> SB180 Posted l/ es ❑ Rermit Posted T` PeYles ❑(U Re-Inspection on or After:-�1_�/.`�� Qe r—� <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 1 e U rC nu tne4w�, coc.k,-roa.c h_.c,- can Tr�e Sfi fi R-c, S <br /> lace S a - <br /> Z <br /> - <br /> 3 I ae McA nkAtu«r n U j)AR_ U ad r esS cm Tkl� <br /> }P-M S • cm Q L+ in \ vJ e <br /> Mnav-ii)z c#wp i4e ';MPS -n v�e��. <br /> FOoO monU s tificgl+e rS v un S e. _fN <br /> in Iwo <br /> •TC&rL 1�, no ft_�- WOW In ThZ -Fu cn l "IrtQ Mrd--�- <br /> WG ker U \2U-V- cal- The, 3 c c 5t n K u \130F Ot IhL <br /> awl fr�dSirt n i Ccn1 fit u-e v-G i n S \gvb 1 <br /> ll jill <br /> �Ir 1�cn�� e �¢12vi a+S crr fi n U+ <br /> _ _ J►r - _____ -- - _ Si fi� _ '�Gint�il n G C5 7z� - <br /> 01717 ul1 rrt P� <br /> IE <br /> ame: Hand Sink: of hlorine: ppmHeat: of <br /> xp.Date: arewashing Sink: of lQuat.Amm.: ppm then. of <br /> T I� <br /> Received By/Title: c� r- <br /> EH Specialist: , Phone: 200 b8 3 1p <br /> Time in: L I Time Out: O f7 Page f <br /> EHD 16-24 (2ntl pg) 4(3/13 FOOD PROGRAM OR CONTINUATION <br />