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SAN JOAQUIN COUN <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siciov.orgiehd <br />FOOD PRO9RAM OFFICIAL INSPECTION REPORT <br />Name of Facility: il 0 VJ ' ii 6 Date: <br />Address: <br />') <br />City: Zip Code: <br />c-4:44 <br />Owner/Operator: <br />--S- -<- 5..0 e_ 11-&Y-tqck qd--Q-% <br />Telephone: Lfr./15--(41 <br />Program Element: Program Record: it:7 .5—"Ct -7 ....2 c.7? Inspection Type: <br />SB1 80 Posted Yes ) Permit Posted Yes - - Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />- h0 . a 4 I U(:-itir- 1- _ - <br />0. ...)C Ck_______14-° - ( C)1kr / Ak_arLA--161AS_Iev_i <br />a 0 '' LI IL • 4 10(7 — /OS F -r ,___ <br />i oh . a_ b...41.111.1.111.11M ilar ii. A I 40 _ <br />41' S --E z (4ceys. <br />Natct, i4-9 acre 4 <br />915 I gOI d,u r c fat 15)1 <br />or 4-0 t_....._____"...„.., a A NiikvID, .41 <br />, <br />fa_ r <br />Item/Location Temperature Item / Location Temperature <br />- <br />Food Safety Certification — _ <br />Facility Hot Water Temperature 1Narewashing <br />Name: n i fo ri ci u _ Hand Sink: <br />( 7. 0 <br />5 F Chlorine: 73( ppm Heat: °F <br />' Exp. Date: f <br />tk /Z1/-Z- <br />Warewashing Sink: <br />/ CF Dual Amm.: ppm Other: °F <br />Received By / T le: _ , . Ar, , <br />EH Spa._..--j;', Phone: 411111141011f0 <br />61.1(13 <br />LI, 6 a...- __40 <br />Time IW Time Out: Page of <br />EHD 16-24 (2^d pg) 413113 FOOD PROGRAM OIR CONTINUATION