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SAN JOAQuIN COON <br /> ` + ENVIRONMENTAL HEALTH DEPARTMENT <br /> Y. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �a•.,g ,.��P Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.siQov.or_ lg <br /> �fFOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: rc hC r. 1e r Date: <br /> Address: '23 �+G city: r G ` Zip Code: <br /> 1. 6 S4x/ $ 3 7 <br /> Owner/Operator: 1 h G M P G Ql i f9 L Telephone: q t 3 12 &.2- <br /> Program Element: 16 6 3 Program Record: 6 Inspection Type: CG S(4 449 <br /> rev 1% <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> ..••tom.. .�N�. ._.,.,,,....t..i..-.„ ..V• .. z-.;.".2x';(,-:a•.,. - .•>:;ra"crw;=:4' rsxu <br /> '..; 'Y`¢tx .., � ti'x as- a.:v-,•re.uzC�J r s _ t i�sC s•iw,?�'^1i""'�'St ;3-'e .� <br /> >. ... ' ra _ r3 ,U�SER1/A {]1+IS AIV�xCRRECTu � N`P' s ,., .. � � <br /> 01 <br /> ;t pUjr3 t <br /> i <br /> Pro 1) de Z; Codes 6 n h iiih YkA,4 ale. <br /> CG rn,.15 be, M of } reZ54 gUr4n pet <br /> d <br /> Sol d ova <br /> Al U c', l e r ce d &1P SA s t Ker 0 b,3 e rvr� <br /> 0 u e r ryl., !" - yr V G1 S Once <br /> �'yck-s: x;..:. :`lei+ :i`'F_" "`�✓4 :x •��Te'm�efat 0? '--" �45 '�r�"�-r. .....r...,R s. �-i�ra.-'f�.x"==.T:�.rt.'s''=�.,�e3z•'� 'sir =�-..xF'�'Si=�"r•�:=",. <br /> temYlocat�on . - c •. w; _.R.__._ _ _;::aztem fLoeat�on � t�er� rati�re <br /> olr/y)pr <br /> P <br /> 'u�.,£'y`�'., '✓. _ '":.c..�-'x .s,-:.-.�.';:c.-=`ir,'=- � �k_��i.'.y.W 3'*;•,y-a;..wc�,`.r�v::.i•- -.:!�?;�...t-�'-�:��r��:,k�4�...?5r:s'_14�-��-�.-'s"�W3iewaStli[S••�Tr'`' -_'�.�y9-x•«.rr�'1'� .. <br /> ' ' wMf�Food�afetjreCertifj'�a'tton :. �4 _ter Faail�tyHotWaterT.em nature ti.� , _ . .,Fs. :9s ;r <br /> Name: Hand Sink: aF Chlorine: ppm Heat: -F <br /> Exp.Date: Warewashing Sink: -F Quat.Amm.: ppm Other: 'F <br /> Received By/Title:. �Z <br /> EH Specialist: Phone: 3/17 OY <br /> Time in: Time Out: p : Pager of/ <br /> EHD 1624 (2'1 pg) 4/3113 7 FOOD PROGRAM OIR CONTINUATION <br />