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SAN JOAQUIN COL ry <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siciov.orcilehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: VA2A v r c cAl-u 11 It 4 vF Qto c,.. --L, --) Date: cv2_y 0-- <br />Address: 600 -9-WN cl <br />City: Vcap9-7), Zip Code: C.? .i2F3 4_ <br />Owner/Operator: Telephone: <br />Program Element: 36 Program Record: 11 5 4 i 3S+ Inspection Type: <br />SB180Posted Yes Permit Posted Yes Re-Inspection on or After: . <br />OBSERVATIONS AND CORRECTIVE ACTIONS, <br />6) 't)C,01 Ce/r44:10 C,U rient 41h .0( mit , 0 na v7ceAlcuS f , <br />r-ok-b-r--Jk- ace \--1.0- on cl-W. wi• i n ct covAl 1 on si-4e <br />04- 011 --hmo-S <br />@.) OK-eiyo_ci f2A-np(cm_eC. htora.i2, rncrne‘i Then uCce, \l aid <br />ccctrv-h. A„eftic..e honoul n.ci overo -i n papex- <br />' <br />s virrx-T6t1 <br />et, -i-v -1 \,,sush \-00 ot --\-\-vo <br />ho •ii--).- viiTh ' &oc,t - worm <br />cdri,e6A-e6 0-\Th E3.1- k <br />0)) t•cO Cfilovi N2 -sea- c-trl tit r .4 <br />, . <br />‘C-x,i_eA -1-7.ac-m‘ <br />v-0146 aF-4-or" A-eiS civ,e, <br />Item/Location Temperature Item / Location Temperature <br />Food Safety Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: .F Chlorine: ppm Heat: c <br />Exp. Date: Warewashing Sink: c F Quat. Amm.: ppm Other: . <br />Ai Received By / Title: <br />EH Specialist: a <br />Or <br />alltioNli <br />0 ... P cylkir Phone: aLCI .„ <br />Time in: Time Out: i I : 36 Page o <br />EHD 16-24 (2nd pg) 4/3/13 <br /> FOOD PROGRAM 01