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SAN JOAQUIN COLD <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orq/ehd <br /> <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: VO M41 0 rizodu (42 -14E -;6( li 2 I Date: y 3 67 ja <br />Address: S Mok ry fi-Nf e City: gztli, t Zip Code: Cis 2_61::3, <br />Telephone: Owner/Operator: <br />0)VOYCI10 \ 01Z?irdill C5 i , <br />Program Element: t bAe.., Program Record: soF-ji (..) t; I Inspection Type: y2zurt-itle <br />SB180 Posted /Yes 0 Permit Posted 0 Yes /I Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />(1) V-MICA .1 seiii i nq pa FG <br />, <br />DA yet 11-" a& Ati W Tee led picafniinK <br />--to day - oc)\ \i) ,c501 \N b oQ v g-od Lite, , <br />( uvieint- -ka 11-1-) rrN \ k- r)oi-- GI\ s 14e ketiole-a -rn (A <br />c(17,4 op ,c-4e oi- al 1 -hictc <br />-y- 0- Tv s _s\ /Le- 32AztnA-cir <br />k Item ocation Temperature <br />...._ <br />Food Safety Certification <br />Name: <br />Facility Hot Water Temperature <br />Hand Sink: .F Chlorine: ppm <br />, <br />Heat: °F <br />Exp. Date: Warewashing Sink: . Quat. Amm.: ppm Other: °F <br />Received By / Title: _ ------, - <br />EH Specialist: Kdo <br />/ <br />WIMP A w <br />Phone: Ci S 4 4 Lf_c, <br />Time in: 1 1 IQ Time Out: t ., y)...... Page/ of I <br />END 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION