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SAN JOAQUIN COUN <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siQov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />t.----, Name of Facility: /1/tdi ,..,_.1 j.?. --aa,..z- e____ ,_,CY--",,./ #/7 Date: /'e,/c7/4- <br />Address: 0.5---77,2_ .....p eFE .D47.......,:i c. ,..-F3Lz City: 40,..7 Zip Code: 75—gzcz, G. <br />Owner/Operator: (.1F/A.60.-c Ar, s- <br />TelephoneLs—v9_ <br />Program Element: /d' y Program Record: c'55 7"P-7 Inspection <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br />,.., OBSERVATIONS AND CORRECTIVE ACTIONS <br />rA-74-1,--a— (S- Mzri-- eRitotif 44-e.._ 0---7 ,57-/-C.. A-444-piire-pi-7 'Ipt,/,• <br />ef- pef -4.4- / tf,-7 j' el---e- al-Z -74P ei,"--- <br />Ai 66-1-- c-e,c--e."1---- eT e-eil—E-o.--4- IS-, 1.4_ 11— a.....,..,:der-Lle <br />tfrt,,,„,,,•,,H-7,..?„- .frn .si-L tv._ <2 €4,1- ,---e-p------1-- sw--e- ea-r— <br />ez-C-C_ 1-7•1-1- -e....r- <br />'%_g I g- 0 s.S1131 `4' e_ es .14, 71-- -z:, s-9-- 0 5f---e_c( p <br />42--Lt S.- /o c: 'm -3 c4/-- <br />(y <br />CY <br />Item/Location Temperature Item / Location Temperature <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: o F Chlorine: ppm Heat: o <br />Exp. Date: Warewashing Sink: o Ouat. Amm.: ppm Other: 0 <br />Received By / Title: <br />EH Specialist: Phone: (74-6,—.713 ":..5--42...._ <br />Time in: <br />N 1 <br />Time Out: Page of <br />I <br />EHD 16-24 (2°p g) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION