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SAN JOAQUIN COUN 1Y <br /> (�j;'� <br /> SG�aENVIRONMENTAL HEALTH DEPARTMENT <br /> :4_ 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> ;PTelephone: (209) 468-3420 Fax: (209)464-0138 Web:www.s"gov.org/ehd <br /> oR"� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: L u S G L, Git'n WQ <br /> Date: bIV <br /> Address: 1(s s . CCI ( l n( G City: Stz)CaC- Nzm Zip Code: q gp�Glz;- <br /> Owner/Operator: t G b0-&D IMd rCklk, Telephone: <br /> Program Element: t Program Record: ()G '2-q- 2 Inspection Type: C('PSN �Un <br /> SB180 Posted ❑Yes C] Rermit Posted h ❑Yes ❑1 Re-Inspection on or After: -1-12 <br /> -" - `OBSERVATIONS AND CORRECTIVE ACTIONS � C� <br /> Ll F-uCK .4 (o-9 25G f,- <br /> (J� Uvi h(L-A M2 0-V UwrlPX CT� � S�GIpS C 4,e *�CLe- <br /> i Li i"S o 6k- ward pno JbF,14 need I'tCunno issue :lrm.r�- <br /> Uhh1 ! G{-e fiXzo* <br /> N� Soo GonCA rd nv-- wets �Aocr-ec C"-ce 0n s1+P_ <br /> C M- idle ct e Sh w ar er CW4 vra y-e wc+vc u <br /> e Sctee nS reed tU �e' r Tlciced <br /> s n� �� cloyvdfiWc�l <br /> CA' O VOCxI n (@ V�zfNiCW_ G ►rS " (,,kid ik <br /> Cq 4 F6z—oc ( Q) -Wj-e Gr'rQ T S hGcno C � <br /> OL fi'-eSh wt�1-E'-r �UN(i(IP '-UCd 1Aot)O r ` S , f-oad A\CAh t0-r CCA r6 D-fl <br /> lG _ �n1u h ad fish -0S afe ms nq <br /> f b%A Th2 cP�L, n s r✓r��11 a� the Gl ri v,P�`S SI C� h�1 S fi-i ►�+, <br /> i52 rp Gvv rkalf S tum fi ail U wc�c�. '=+ <br /> _Y-_ cd tvcq�Laf cckr0 c/,i,\ r+-le <br /> c Mi SSGt o� colt fis wcra . 'rix �bcv'k �' ' all 62X'MVV <br /> ve Gh CA,Ir a PV-0 v+ r -nY-- �cr�( i Obi <br /> lvCti o On or rzAke oto, roM* d 5 in Onj <br /> C) N-1I re G_�G ed Codd Cci <br /> �. <br /> Location Temperature em erature__ __ . - - . . _. <br /> SEe fi�+6�5 1+0&T vii II lns 7c�;cm S <br /> CcAP-w i ckSI cc <br /> .. _ rT <br /> Food Safe £ertlf�cation Facility Hot Water Temperature tNarewashing <br /> tY ty pe _ � _ <br /> Name: I � Hand Sink: 'F Chlorine: {}\( Y lu ppm Heat: —y�- ---oF <br /> Exp.Date: ' arewashing Sink: of Quat.Amm.: ppm (Other: of <br /> Received By 1 e: <br /> EH Specialist: Phone: cq 4&(:b 2 <br /> Time in: Ci -15 Time Out: 1`. 11�7 lJ Page +of <br /> EHD 16-24 (2nd pg) 4/3/13 . FOOD PROGRAM OR CONTINUATION <br />