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<br />..o SAN JOAQUIN COUP _ <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.orq/ehd <br />to: l iftleg' • <br /> <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />- _. (ei, Name of Facility: S VI 0 CO 1‘ t 60 vteS . <br />Date: //.._ /,4 <br />Address: Zip Code: — <br />3 cre3 N , Lod C i'l, Viaj <br />City: <br />"t0 9.5 2 OS— <br />Owner/Operator: 5 CideVI Telephone: <br />Program Element Program Record: pR oc--3q-- FS' Inspection Type: gois.41 tiit...e <br />SB180 Posted Yes No Permit Posted Yes ' No Re-Inspection on or After: <br />.., <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />HS 14-y4 - sir kcd. .-i-cLaold p <br />i\)(9 t-eaeru,',(&/245\,,s' <br />, <br />0 lay 47/1s-e-v. Pe------: 71 4-.17-- Jo 22) 41)1(1L t .,_ <br />Item/Location Temperature Item / Location Temperature <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: .F Chlorine: ppm Heat: . <br />Exp. Date: Warewashing Sink: . Duet. Amm.: ppm Other: . <br />Received By! Title: <br />JO 6 / 3 _ _ 7 6" <br />EH Specialist: Phone: <br />.2 42q 9A/5-13 1-44S ' <br />Time in: i 2_ ; LI C ut: i Time O <br />PI I <br />Page of <br />i <br />END 16-24 (2nd pg) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION