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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.orceehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: Ro, ce no !_r e.A.Li" -40 Date: / /— g _77 <br />ddress: r5 csv /t/ ahrs#A4 <br />A <br />(day City: ef /: PY1 <br /> <br />Zip Code: <br />Owner/Operator: Telephone: <br />Program Element: Program Record: p Ao a se-- 3 el T- X („ Inspection Type: letnt,% <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />A.4.11 '1-1/J4 --ja f-ed eii-,- 6..-,1 f --- /ICS <br />-C -ed • tit i 1 C--F - 1c4-1 ---1"Wfa: - <br />MO ( E. 0-ea lifk, <br />Ova 2- c7 2L) ble° 'I4-7'tee j41.9 15.5 (..“2_ --2-1- <br />.,.... <br />Temperature tern / Location Temperature <br />Facility Hot Water Temperature lir Warewashing <br />Name: Hand Sink: o F Chlorine: ppm Heat: o <br />Exp. Date: Warewashing Sink: o F Quat. Amm.: p p m Other: 0 <br />Received By! Title: <br />41 qd0C9-6 Z 'Oe' ' <br />EH Specialist: Phone: 2-a9 es 3 -?- ? ,7 <br />Time in: q i' hi 675Y/ <br />Page o <br />q/0 <br />Time out: <br />EHD 16-24 (2"1 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION