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SAN JOAQUIN COUNT <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �q., iP• Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> a� rr2F�) FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: L L I N JC Qt, (,TZG.� I ,S� k('F-SGC W -+- Date: -t 22111S <br /> Address: }jam �U V-16 I� VJ CA City: CJ S Y fi Zip Code: Q <br /> Owner/Operator: if (, .� 1 C i�L r Telephone:Ci Ila-Z-}) - +}-Z <br /> Program Element: I�0 r5 Program Record: �l!`b (��>�3 t I �0Ut 2Z� Inspection Type: .�- <br /> B180 Posted E Yes ❑ Rermit Posted I� ❑Yes ❑1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> v i �� i=occ� MCshQ `� Sc� U�►"fifi cq <br /> _9)- CACX-0 S o c� MUhU W_'r MGtfiuP <br /> 066r,2_6_ <br /> J� t0C <br /> ttemtLocato vzg: Temperature Item!Location -- Temperature <br /> Food Safety Certification Facility Hot Water Temperatures War ewash ing <br /> Name: Hand Sink: + 9 U of iChlorine: ppm Heat: of <br /> Exp. Date: arewashing Sink: 0 L� of Quat. Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: �rte--}_ _ f <br /> Time in: �� Time Out: W1-4v ?U Page of I <br /> EHD 16-24 (2^'pg) 413/13 FOOD PROGRAM OIR CONTINUATION <br />