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SAN JOAQUIN COL: Y <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 />r" -e (04Ci <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: 9 $ _ca,ri •IF-oodiit-9)i- to ,-7, 4 -1- ‘c...; Date: <br />Address: '7.42_ &, ti 17(XCIa0 City: f...vto (Act:314 Zip Code: 015206 <br />Owner/Operator: bi.eA4 on() 01 UC51-106 STA eri Telephone: 64ci_ expsn k <br />Program Element: k (4, (0 Program Reeord: ?r.or., (0 .2 Inspection Type: F..._UkAtifite. <br />SB180 Posted `ifes No Permit Posted it No Re-Inspection on or After: -- <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />cD sawi t-i_ioo otre . f..7 1 ace 1 NI r2- NI4 eeAcS) • urcit cxed <br />(a) l ioi-- CO c•eQ -c---cod k-‘as I Le, on -The AA CurcE (>4-- -tacicN <br />t-41 oNt 1 s2o, fr) od i .F-co,-)?944 ocr ii-il s -Yirfle <br />C?") Ittere 'Vs 01111 c5r1e sAaqw2A- -VCAr- 11-\.2, S.S TS Pcbv <br />)(-- or- iv vsS\AR, peinTik <br />ocf-A-er x.e.es,1---- aT o F oo 6 - <br />--, r &•,,,,, , (Lktc> 1 t;...-tc, a C <br />Item/Location Temperature Item /Location Temperature <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: c.F Chlorine: ppm Heat: °F <br />Exp. Date: Warewashing Sink: . Quat. Amm.: ppm Other: °F <br />_......misim... Received By / Title: <br />EH Specialist: ' --moini.i......---", Phone: exci iii_&.b _f7) 44c IIP "AI <br />Time in: k , 0 c-- Time Out: 1 ..,., 1 0 Page I)f <br />EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION