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SAN JOAQUIN COUN <br /> � •.OG <br /> Q` Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sagov.org/ehd <br /> �/FORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: b�'bo-Z Date: <br /> Address: Z v? City: qvzqNv,., Zip Code: <br /> Owner/Operator: uaN I v �k� -I �� Telephone: <br /> Program Element: Program Record: 53� I Inspection Type: ly�� <br /> SB180 Posted s No Permit Posted (>/ <br /> s No Re-Inspection on or After: C� <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> PVdA A So w' ' i w ooJ h <br /> Item/Location Temperature item/Location Temperature <br /> - - --- - <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: Ppm Heat: 'F <br /> Exp.Date: Warewashing Sink: of Ouat. Amm.: ppm Other: 'F <br /> Received By/Title: <br /> EH Specialist: 1 Phone: <br /> ime in: Time Out: `1- Page of <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />