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SAN JOAQUIN COW% <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orgiehd <br />OOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: g rs,e_ iv i n ..<-_._ 5- (Cat4--$) -t - (614 t'c<k Date: ‘, k 7 1 3 /it, <br />Address: City: ,:ks i Code: <br />_35570 - Owner/Operator: <br />C il r 7,941 n CL- 71'• Telephone: (57 <br />7 7'° <br />Program Element: Program Record: <br />--e12-- _ "Up Inspection Type: J r.o Lterr <br />SB180 Posted 0 Yes i Rermit Posted fl Yes 0 I Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />---7Z-: ill 's Car--L_ -f-c r _........, , <br />saJc..e_,-- <br />a Sco 1 A C *2- -b4) ect c42 . .3.-- <br />C too Coo p 4-1-T Aycr>cl__ C i (4> .4r;troctii <br />decl 410 f -"Cir. C YAM 57,. .,.. ecy <br />Ma AV, 4`fr , ' lefeNi , 0-10....., f/w.k. \C S kia i cull . . ..._ <br />c do • -12(10 1) i. o.z, 0-ru__ 4-- cw. ...poi, . _,,, • al isA._. 0 I <br />6 gira1141 MINre lAllW 'k 0 r <br />-et: I. • . .... . ri-S A 121 ......_ Pi,r) .. <br />• eNrk- 3 0 r - p el-- it* c_.,s;Ao ,12€._ <br />r tAi 11-e-r- ri 1.--r ftec ...,z.).. _ 1 A ctC-Ei • ___•INMIEMIerimfflr <br />0— AS)ete-'‘i i ce • i..4 • ao A AI 41 .. ,.., --i-)1 _5 <br />---Pc, r al .. 4/OP Old- Ili Al <br />7.72 <br />im lEth. A 46 g° IAN, ....... <br />CCIP-E____ 3 r; --1-n op I. s. k Taal - 4,.. f .k _.• <br />, n c( c-f--,: v cm_ <br />Item/Location <br />Food Safety ertificat'o <br />Name: • i 0 <br />T ----, <br />1 Temperature 1 Item I Location Temperature <br />Facility Hot Water Temperature — <br />. <br />Warewashing _-- <br />Chlorine: ppm <br />— <br />Heat: Hand Sink. °F <br />Exp. Date: <br />5— <br />2 0 1 Warewashing Sink: uat. Amm.• ppm Other: °F <br />Received By / Titl : tL 4'&i- <br />EH Specialist: <br />"e--1) <br />Phone: <br />Time in: Time Out: Page/of <br />EHD 16-24 (2,4 pg) 4/3/13 FOOD PROGRAM OIR C NTINU N