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SAN JOAQUIN COUN <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.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Date: i L - 0 -a - t 8 Name of Facility: AJosi h tit..ii ti A, c,, y(5 . <br />Address: 3 si-0 md so.NA v jam City: 54.04( i 7 /TM <br />Zip Code: <br />Owner/Operator: eit i/s4 pl, pri--/e4,1 fej . Telephone: 7 2,0 ,,,,,, <br />Program Element: Program Record: Inspection Type: <br />7 <br />11-1‘11.144_ //7/e 0 5---firl5i <br />SB180 Posted Yes No Permit Posted 40 No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />Foed .1 / Ced-174 - -a k -4 - 72e /- c 4%1/2112-0 Z 3 A. <br />d <br />' <br />" i IA4/1 ie, v No iztv-de4i-4. 4 4.C.1.....--/- oll"-c ciLt Si ,nis-71- <br />H. LAJ 5 ii4 II rtrAet. 4(10_1 YO 141-ar • (Pre7 Wide ee:2./.."-v <br />c 0 vY i, r I--e,1 cv, s t r-:e..._ ,J <br />No n A(/' 4 lij 42f 014 r • <br />(3 I( IT .... '2,e) /1 al-cee 'e--- .5 pe-v6---t- ,/e pe-ilsi / <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: °F <br />Exp. Date: Warewashing Sink: . Coat. Amm.: ppm Other: °F <br />Received By / Title: <br />'tti7°6 <br />EH Specialist: (---' Phone: 2to 4 I 4 — 3 7 _ ...% T g r_i,vfrpt--td._ <br />Time in: q ; 30 Nt Time Out: 1 .,/,144 Page of <br />EHD 16-24 (2^' pg) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION