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SAN JOAQUIN COM <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: wvvw.sigov.orcilehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: m ii (' Date: /2_, s---4 2 <br />Address: `'.0 2 C 57-- 612eb; <br />City: 7 , 9 ,c_ Zip Code: q 5.... 6 3 2 Owner/Operator: <br />tZ4 <br />Telepho • <br />-4-tiva_e t -z-ei-f-i.e.L4 6 <br />Program Element: Program Record: <br />/7/V r S -3 ,_,--,, 3 Inspection T : <br />SB180 Posted Yes No Permit Posted YesNo Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />Vtia4714— 1 13 (--- <br />/IJ / / <br />110 ztati‘tie e i A - ?I /1/01 eo f ) .1?/ , .573 <br />r' 2 ID i in e-o-e7- 1.1 1 beet.e.4 <br />fry/ M atle he_ 0 p r <br />c,a9 ;.,01 ., 41, drnvi, c <br />"' rex4,..... gweri.y.201 rtt€1.61- 13 tiths1A-t cA) it,s, te,--0 \re co-y- v.ez.4,1 .0.1., y i 5le <br />4 PA r J , / ,,,, <br />a ‘2 1 01-\ -‘ <br />2,2/9' <br />Item/Location Temperature Item / Location Temperature <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: i1 t:21.44614 iew i t 0 at Hand Sink: .F Chlorine: PPm <br />Heat: . <br />Exp. Date: <br />70 240 <br />Warewashing Sink: . Ouat. Amm.: PPm Other: °F <br />Received By / Title: r- <br />., i—../....... t. _ <br />Eli Specialist: Phone: <br />0 !IP 2,LA9 q 9 5 3 <br />Time in: Time Out: Page of <br />END 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION