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-Fr-o/e 7,s 7 <br /> " <br /> ° I" SAN .�OAQUIN COUNTY <br /> P •� <br /> 2+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �;.• �� �P Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> �IF6RN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: S U U -:7 13 V Date: <br /> Address: I i/ City: Zip Code: <br /> Owner/Operator: 11 Telephone: <br /> Program Element: 2 Program Record: f2p,,Qo8tq711 <br /> Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 016:/1�0 J 5 <br /> Sze <br /> 2 <br /> ✓� z - <br /> s <br /> 2 - ep A,07� <br /> Item/Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: Time Out: Page of <br /> EHD 16-24 (2,d pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />