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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orgiehd <br /> <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />A A 4c-it # 2 (41.4.44-ro i Date: //... / ,.../ I *Se Address: <br />35 N W / (SQVI <br />City: fiz2e00_, Zip Code: q c 70. r <br />Owner/Operator: Telephone: <br />Program Element: Program Record: <br />PR Oce),C 2' S I Inspection Type: <br />SB180 Posted <br />L <br />sNo Permit Posted Y No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />OAA4A1.4,- • / I S . 1- <br />a / C Cyat_e•Leisiol % ) <br />c <br />02 0 0,4_e_g_ I c <br />Item/Location Temperature Item / Location Temperature <br />Food Safety Certiflcaa Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: .F Chlorine: ppm Heat: . <br />Exp. Date: Warewashing Sink: o F Quat. Amm.:. ppm Other: <br />Received By / Title: II LA. (nte mg, <br />EH Specialist: <br />411IM ALIMPP---:.. <br />Phone: 2-6'9,? 5-3 7-- <br />9 <br />et_____ <br />Time in: <br />4! /C. <br />Time Out: <br />/ ! 349/frf <br />Page of <br />EHD 16-24 (2., pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION