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P411N SAN JOAQUIN COU4k <br /> y-+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> W .. X <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: rP o n 5 Date: f <br /> Address: rn� City: D Zip Code: �. <br /> Owner/Operator: nJ Telephon <br /> Program Element: / a ro ram Record: /Z p Inspection Type:AlIn <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> clk S ;4151 7-14 <br /> US - <br /> �•� P :3� K L! !2 � l 7'7 <br /> 0 <br /> 1 Nrri O <br /> 0 <br /> ra rci m F-P e- 3 ? <br /> Item/Location Temperature Item/Location Temperature <br /> i r .7D r - - <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: jj a Sink: � U of Chlorine: ppm Heat: F <br /> �l •e Y/74'-? <br /> Exp.Date: _ _ arewashing Sink: / 7 'F Quat.Amm.: ppm Other: 'F <br /> Received By/Titl - <br /> EH Specialist: / Phone: 1 • , ? <br /> Time in: G�4 Time Out: F," Pager of <br /> EHD 16-24 (2nd P9) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />