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SAN JOAQUIN CC 'TV <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 />Date: 1 /2.(..)/ / Name of Facility: gtNicANI__e. CLA. 0- 4 ,---)2 <br />Address: Zip Code: q<z ti c- <br />-"-tip V/ 1 City: 6_1v tv..1,4 <br />Owner/Operator: WI IV 114- --g 4_e- Telephonyz09)51.0 -29,01 <br />Program Element: i tc,-22- Program Record: ) g L) 9 7., 61-4-?/6 Inspection Type: „goitti ilk_ <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS -k.,- <br />0 qt.: haS ee-cActpci 'ff2NIO62 11te_ -vo llowln va 9,0ar-, <br />1??.,t ri n e cs Ty) me .9t=tt- <br />cv\prt.u-rs f-vm-e_ 1 " <br />Dril c-5iii-i-e tbi \7( c cu- -. ' I <br />4ect \Al-) 17-QAm uncl pcOviuts <br />Dr) --i-e - mciintcon 0 rT1 (3r) s1-4€ o4--- 00\ -t1(72._ <br />• 616- -h rssvce -1.i\I-1-- -\--uc 2D1q)1, <br />ac-7--leA-- -n-\Q. -k-ee.c OVe vo-id <br />Item/Location Temperature Item / Location j Temperature <br />1 <br />, <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />• Name:k i _..,.. C 0 t..._ ...i it, i — <br />H ann: d Si o F Chlorine: ppm Heat: 0 <br />Exp. Date: <br />I 2 Warewashing Sink: 0 Ouat. Amm.: PPm Other: 0 <br />Received By / Title:. 4 <br />f,o . <br /> <br />Phone: ,-;_, LL7-4..... zitc,....34,11., EH Specialist: i <br />VI 11, Time in: ID- c).\--- i Time Out: 1 1 c Page of <br />, <br />( <br />EHD 16-24 (2^, pg) 4/3/13 <br /> FOOD PR