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,oPa .coG SAN JOAQUIN COUiul: ' <br /> _X ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:{209) 468-3420 Fax:(209)464-0138 Web:www.si oq v_or /c�ehd <br /> L�FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: A n I el 5 Date: <br /> Address: O CCL -rVn-L-4 0. City: � � 0 Zip Code: -5203 <br /> Owner/Operator: lin 1' ( a u I Irl A14;kl Telephone: (130.,q38/ <br /> Program Element: t(0 031oo I Program Record:- S R Cin� I 1-)^ Inspection Type:/t„n 0 Hiltfo <br /> SB180 Posted Yes No Permit Posted Yes No / Re-Inspection on or After:W I' <br /> OBSERVATIONS_. D?CORRECTIVE ACTIONS: <br /> C, 'I (0-7 D <br /> Srr?---.. -G`1---b <br /> ---x- - <br /> 1 <br /> 01� 6cxo-en 5 _fVrn b_ - `,yJ"e'(C --- - <br /> -..__._.... <br /> 0 ' K "('u LbScw rrn i-+ Pro Y--L)rn I(o v5 F-*e. A ?,O <br /> Q ` __6a4 ctr ca - -1 s <br /> Item/Location Temperature Item 1'Location Temperature <br /> bak 35°F <br /> Food Safety Certification Facility Hot Water Temperature -YYarewashing <br /> Name: 'I t>1 Ie h Hand Sink: lag of Chlorine: too ppm Heat: F <br /> Exp.Date: _ _ 5 <br /> rewashing Sink: of Qt. mm.: ppm Other: of <br /> Received By/Title- <br /> EH Specialist: aLI/I Phone: <br /> _ .. ........ ............_....... <br /> Time in: ;Ljo Time Out: _0 Page tof <br /> EHD 1&24 (2^ pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />