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SAN JOAQUIN COLIN <br /> � •.OG <br /> .Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �q..�j PiP Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.segov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: fir,` r �J Ci Date: <br /> Address: �- S. City: Zip Code: 3 <br /> Owner/Operator: � G K�/►— Telephone: <br /> Ac n 401 -46971 <br /> Program Element: 11(0�;n Program Record: t? - Inspection Type: _ <br /> -"nQ <br /> F!T8-0 <br /> Posted es ❑ Rermit Posted es ;- I Re-Inspection on or After: 10/11)"54�"54 <br /> OBSERVATIONS AND CORRECTIVE ACTIONS I /. <br /> / UnC1 ;C1 t oto CA( y' <br /> riot kS PC <br /> CA Stzlf-ed riz.Ojevod - Gre <br /> c)h 1w - t T),w r-e TbZ COCYLOT I& wCnY-*wf <br /> Ur (2 1 CNN . <br /> we of-j <br /> "QA1,e iZ6\aQ Ord e p W dc�TS G`o <br /> 1 NU OCI bKOW4 CCAk' Q OCk S . <br /> c A- crr\ Si Ae_ i nto n <br /> Y- C W)P0t h)t t v t-�A- 0 n s j2CA cM <br /> iS <br /> Item/Location Tertlperature Item I Location i Temperature <br /> —...... ............._... <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: of uat.Amm.: ppm ther: of <br /> Received By/Title: <br /> 4.- <br /> EH Specialist: Phone: ro <br /> 405 , 7n <br /> Time in: - Time Out: Pag f'Z <br /> EHD 16-24 (2n0 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />