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Item / Location Temperature Item/Location Temperature <br />Phone: 4{cce). <br />Time Out: ‘1 Page of ( <br />FOOD PROGRAM OIR CONTINUATION EHD 16-24 (2^d pg) 4/3/13 <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />CkCX wi-n-Ncvq- ckOS <br />orld t.? e4- t c&a <br />-1-t> SS 7AXfli x <br />4-e -1--aNie ycid <br />Facility Hot Water Temperature Warewashing <br />Hand Sink: °F Chlorine: PPm Heat: <br />Warewashing Sink: °F Quat. Amm.: PPm Other: <br />Food Safety Certification <br />Name: <br />iquUr-0 <br />nU-kt teX <br />EH Specialist: <br />Time in: <br />Exp. Date: <br />Received By! Title: <br />SAN JOAQUIN CO TY <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: t 1 1 aro,c_.) 'A$ k,o \./ 1-k I Date: /24,0/ (1 (C <br />Address: ..„0-1.C.A-7.1C4 /0(1\1 <br />City: c..L.:1, c_ Zip Code: <br /> <br />Owner/Operator: V-OkA ( ))1.1 Ce \IC* <br />TelephoneR (e _ tc63 ...4:N5bc- <br />Program Element: 1 (D -40 Program Record: 17 0 46 (0 COCI Inspection Type: zzinr.17. <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After:—