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Po 5-1- /94.44-pt <br />X, / LcSIA-e- <br />SAN JOAQUIN COUN / <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 />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: c o tAi t, p Co frt.e...i . Date: 1 2, 1 <br />Address: City: <br />35-CO WilSdli kAJO-3 • <br /> 5 +0 c_ Zip Code: q <br />Owner/Operator: le• 774..5. ,,, , <br />.- 11.71.--1- tel 2-i 0(4-— r. <br />Telephone: <br />4 f 36-4 g'). <br />Program Element: Program Record: •pRos-3 ,9 _2.wg Inspection Type: <br />pe, (An t' <br />c i• g <br />l Y <br />SB180 Posted 420 No Permit Posted Yes CN3, 7 Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br /> <br />71-raie--4 34/ <br /> <br />w <br /> <br />-, <br />s1dtrrlLc <br /> <br />4_0 / <br />Item7Location Item/Location Temperature Temperature <br />Facility Hot Water Temperature Warewashing <br />PPm Heat: <br />Food Safety Certification <br />Name: A. bs I, S retit Pri....01 - <br />Exp. Date: I 2-1 I —L-0 2, o <br />Received By / Title: <br />Hand Sink: <br />°F Chlorine: <br />'Ware shin ink: Quat. Amm.: <br />PPm Other: <br />Phone: EH Specialist: <br />Time in: 75'3 ?€t <br />9/3E7 .19/-> / <br /> Time Out: Page of <br />EHD 16-24 (2,4 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION