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OBSERVATIONS AND CORRECTIVE ACTIONS <br />C9 0 Jb-ivui\GL_ <br />Wit 44- 44 <br />s <br />A/v upt()Ltd -c1 -10 40-(rL, do-4--‹pt otd <br />vv)(AN AkiA Ov24 otA/-0-- icktte. .01,0(AA,Let <br />data-el( <br />3 <br />X Or-- .A4-44m 9-on <br />tewitt: <br />„to aAfA <br />N1/4-)6A7)-A,U1 <br />Item/Location <br />Food Safety Certification <br />Name: in 444e( COW AIA Ott) <br />Exp. Date: <br />1.) <br />Received By / Title"( <br />EH Specialist: <br />Time in: 0 t 9)q <br />EHD 16-24 (20 pg) 4/3/13 <br />Hand Sink: °F `F PPm <br />Quat. Amm.: °F PPm <br />Phone: Lfok- 7a <br />Time Out: <br />Chlorine: <br />Pageef-u <br />FOOD PROGRAM OIR CONTINUATION <br />_ <br />Facility Hot Water Temperature <br />S <br />Warewashing Sink: fj °F <br />Warewashing <br />Heat: <br />Other: <br />SAN JOAQUIN CC TY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siciov.orci/ehd <br /> <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: OCI64..... WI VI c.... Date: i / / II Address: SOD_ c s4-6 ea I- City: Zip Code: <br />Owner/Operator: 0,7 fri c Telephone: <br />Program Element: / if 3 c Program Record: 0 C as / 4,3 Inspection Type: viichea_ <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: