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SAN JOAQUIN COW* <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 />Name of Facility: g C6 S Date: /4 , _/ 5..2.40 . 1 <br />Address: 3 c c0 N mI i /.6.44 ifidty .... <br />City: <br />C414577 <br />Zip Code: q s- <br />i. <br />Owner/Operator: 4. hi, /7 /1.4 Telephone: 2.9.7 <br />Program Element: Program Re-cord: / ) C - 4 4-.7) Inspection Type: 2 <br />SB180 Posted es No <br />- <br />Permit Posted Yes ' No Re-Inspection on or After: <br />. <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />e SttCCE, ‘t9tr,-)1 c:We9-64/ il i F <br />. 1 1) (2,410-e,' kt ( F <br />S -)-e_e.,,,,,, lab& t 6-1) F , <br />g . sol ‘..,t, .c.i.V11-1,, atio-ft\,u_. looppvy, . 0 34 <br />'5 ) --go (A.,( 66; pi_ 441,11 4-3 e no /ma t._eie . "7 -Ca L' ;We &Pt( v eciley / , <br />We ik olp ,t,t) 13 ( b 69)(36.,( is tiq 1 . , L K t LA3 5,te-t..t .... . j <br />q <br />/Nie9 )-teye,,,r fr <br />0) LO X /V i'S S e„( e__ /.---t Y .6r,f - Zc2/ 9 en-t ce , 'I e4 <br />ke, . <br />/`2•'" <br />Item/Location Temperature Item / Location Temperature <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: t.„. r <br />/14 kl, L 00 Hand Sink: .F Chlorine: PPm Heat: °F <br />Exp. Date: II I 2_13 1 2, Warewashing Sink: °F Quat. Amm.: PPm 1 'Other °F <br />Received By / Title: <br />EH Specialist: Phone: <br />Ait44.•? iti-vtietv 20 1 q-' 63 7- e gig <br />Time in: ti ,, /5— /DI 41r Time Out: Page of <br />EHD 16-24 (2^4 pg) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION