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PQ�I" SAN JOAQUIN COUNT . <br /> a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.siaov.orq/ehd <br /> /Foca <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Tyr Date: <br /> Address: 3 'M154114 Kt� City: j t Ko <br /> Zip Code: <br /> S,2G <br /> Owner/Operator: Telephone: y Sac <br /> Program Element: Program Record: Inspection Type: <br /> IS6180 Posted ❑Yes ❑ Permit Posted ❑Yes ❑ 1 Re-Inspection on or After: <br /> -.< OBSERVATIONS AND CORRECTIVE ACT,QIVS <br /> 9 ' 7e , } 06r. ' oCCki WC4 rt U)OS n <br /> S Irl �. ! r � ,�' �c•c�a, <br /> 3F0c 61 box On h ocr. a., 16i tc <br /> i ^C Hip •1 I cor, 1 ��fe .1 J% a <br /> Cc r CI <br /> '3 fdv; A f c.r C1 �,'c1 rc jC4-5. <br /> Food Safety Certificatin Facility Hot Water Temperature Warewashing <br /> M.__. —_- _ _ ___ <br /> __ <br /> Name: jHand Sink: of IChlorine: ppm Heat: 'F <br /> Exp.Date: Warewashing Sink: of !Quat.Amm.: ppm Other: of <br /> Received By/Title-. --:- <br /> EH <br /> itle`EH Specialist: Phone: 6�i J�6� <br /> Time in: j� s Time Out: / Page f <br /> / x . <br /> EHD 16-24 (2n°pg) 413/13 FOOD PROGRAM OR CONTINUATION <br />