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• g oc),Q ahts <br />nt-t- i/rt erv <br />7,194 r c arks ti <br />vuzre ccoml9ttkaxl_ <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />se ck <br />(-7 \ <br />to-Eaftv <br />recor-c <br />Pg- 05 -301 q-Z -4- <br />p12-0 53 q -1-cn ilegt) <br />MS. <br />sb,Q_ <br />0 14 ,4 „).. preti toi-ts vec <br />icryl <br />rep S ere 4e-cl 0-71 <br />0 C 14 re pe r pp ear qsa. ci pe05-347 .713) <br />011 <br />5 141? #62-414/t CO,/ (•& <br />eR- ° ge-eretitr eter /L ets i6aeiit sold <br />Nolity OW Ore eArE rot -30 Off) (2111 <br />Item/Location Temperature <br />°F <br />Facility Hot Water Temperature <br />;Hand Sink: °F <br />'VVarewashing Sink: <br />Warewashin <br />Heat: PPm <br />Quat. Amm.: Other: PPm Exp. Date: <br />' Temperature Item / Location <br />Food Safety Certification <br />Name: <br />ISO YWE- <br />Nxi ctJai teksbi, r vz (1-0 <br />Time Out: <br />Phone: <br />Page of <br />EHD 16-24 (2,, pg) 413113 <br />Received By / Title: <br />EH Specialist: <br />Time in: ( I 1.cf <br />FOOD PROGRAM OIR CONTINUATION <br />IS SAN JOAQUIN COMP <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: wvvw.sigov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: A Elz -- -E (ice 1--- _s) Date: je, /s. 1 7 1 ._ _, • <br />Address: <br />tAy= . <br />55-0 't. iserift City: ......clko Zip Code: <br />Owner/Operator: . r To ' Telephone: zoo <br />Program Element: 7 Program ecord: <br />- L'j Inspection Type: <br />g•t <br />5B180 Posted 0 Yes 0 Permit Posted E Yes E I Re-Inspection on or After: