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SAN JOAQUIN COUN _ <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www siclov orq/ehd <br /> <br />FOOD PROGRAM OFFICIAL INSPECTION REP <br />Name of Facility: L.- <br />.. s t4 p pr- 1 41 C C 1') LI q 2 Date: 7 _ 16 -is- <br />Address: 1 7 1.1 City: S- 4 l e ,-, Zip Code: ci s211 <br />Owner/Operator: <br />JOS L c I, , S 60345 231 6 y Or) ti <br />Telephone: <br />Program Element: 16 63 Program Record: ,5 r - , 7 .2 q 2 Inspection Type: 6., evi w / 4 a 4. 0 fl <br />SB180 Posted 0 Yes 0 Permit Posted C Yes 0 I Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />1_ ; c II 7 )( 5 q e, 9 : <br />V, ci (//4 <br />Sc e eiN Ilti.s c h d g . r<., e 14 r e ' IN. p <br />R f p 1 (4 4 0 h 4-3 PI G / kdiAr ;cr‘:) (c r=zteibt:f_. <br />1 1 17)6?1 4 h. <br />P r 4 v: de A- cod ma h al er Ce 1;fi ce,le 6 0 lays <br />R e p 4 i rs ir los; doo,- i n ( We, e <br />71(1,51; n-)6;n re i yer, a c,-, be i., Orr, <br />+ day. <br />c r 26 IC orN re tes o e b tor i--% • <br />0 1 C. CI\ e (I a LA n th r 11 e GI 4 In <br />_ Item/Location _ _ Temperature <br />IS0 fr; <br />Item! Location <br />kCoLII--,, <br />Temperature <br />y 2 F- <br />Sa epe on I Facility Hot Water Temperature <br />Hand Sink: <br />i <br />o F <br />Warewashing <br />Chlorine: ppm Heat: <br />Other: <br />°F <br />Name: <br />Exp. Date: Warewashing Sink: 1 .) o F Quat. Amm.: pp, °F <br />Received By / Title: <br />EH Specialist: 'Ii Liar Phone: 41e k . i /6 ;- <br />ime in: / Time out: <br />q) i Page of <br />/ <br />FOOD PROGRAM OIR CONTINUATION END 16-24 (2^, pg) 4/3/13