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" SAN JOAQUIN COUN <br /> _ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> <<FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: �` "i r Date: 4/1S-/j <br /> Address: <br /> /1S- <br /> ddress: 2Gi N i 1 d R !ef s� Pr City: Lod <br /> I Zip Code: q � 4 G <br /> Owner/Operator: eOCO hd TDh r �O�- n lil-C�t Telephone:qn c'I _234_ipZo J <br /> Program Element: t Program Record: S U C) ( Z Inspection Type-(- <br /> 6180 Posted ❑Yes ❑ Permit Posted ❑ Yes ❑1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> C P'GW rA r--d ttandtp-f Ca ,em �e-0s ro <br /> 30 CA- <br /> yp <br /> CANC1P/( s Ca " cm Me kcLt of <br /> u I LPik <br /> off- tD 0�-+er -�ee CA- 44;5 <br /> spair) <br /> Gk � C�r� Gi` C�^f't'►m i.SSCar <br /> Item/Location Temperature Item 1 Location Temperature ` <br /> dcility Hot Water Temperature Warewashing <br /> Name: j,, �' Hand Sink--. Chlorine:aF ppm Heat. 'F <br /> Exp.Date: a washin Sink: �(� of uat.Amm.: ppm !Other: of <br /> � 9 i <br /> Received By/Title: �. <br /> EH Specialist: Phone: b r <br /> Time in:5..d0 Time Out: ( n Page of <br /> EHD 16-24 (211 pg)_14/3!13 V FOOD PROGRAM OR CONTINUATION <br />