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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.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />Al' I Cdt/V1— Vp 5— <br />Date: / /t <br />ddress: — <br />3S 0 tA) Asokik. <br />city: f lpel<47)..2 Zip Code: 1 <br />- S Owner/Operator: Telephone: <br />Program Element: Program Record: P ' o5-31 •-g' 4 Inspection Type: iet214_,4 t, _ _a, <br />vx_c_ -, <br />SB180 Posted Yes No Permit Posted 1 No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS 411111=1. <br />, <br />7 et e-e-S" 1-1) fa <br />ilS (24 7-- I'cL4i I <br />P <br />zgo-,c), <br /> M cE <br />41(.....„.2 gal, ‘ok h , <br />is-"'S. LE.,.1---- (-2_e 2(9 evve p-----i' <br />Item/Location Temperature Item / Locat <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Heat: °F Name: Hand Sink: .F Chlorine: PPm <br />Exp. Date: arewashing Sink: . Quat. Amm.: ppm Other: °F <br />Received By / Title: <br />1; q_ 0 75 -71) fv•-e-fa _ <br />EH Specialist: <br />',.,r .All <br />I Phone: <br />IVA! Ldf.dalidie <br />." <br />Time in:Time Out: Page of <br />[HO 16-24 (2'", pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION