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SAN JOAQUIN COUN', <br /> r. yENVIRONMENTAL HEALTH DEPARTMENT <br /> 4: .1 <br /> - 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �4..._-,..�;;P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.si oq v_org/ehd c�\\ <br /> /FOR <br /> 3 Gat- <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: �� `5� Date: <br /> Address: -� Z j - \ /\_ n City: 1 ,v,cv Zip Code: 5 ,Q <br /> � vim-' f"���- �, <br /> Owner/Operator: C& K\e\i SSS Telephone: 2 Z q - �8 2 23 <br /> Program Element: SO2Program Record: 12 Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS ANDCC3RRECTlVE ACT1G/1VS <br /> w Zoo <D-j'4Clz-iLA <br /> Item/Location Temperature Item 1 Location <br /> d - <br /> 5 u 1 r (5v-e�-iJ� u D F-- <br /> Food Safety Gert�flcattan y I acil�ty Hot Water Tem erature "` t aewashing <br /> Name: r� Hand Sink: � -F Chlorine: ppm Heat: `F <br /> Exp.Date: \� iewashing ink: *F Ouat.Amm.: ,Oppm Other: F <br /> Received By/Title: CA <br /> EH Specialist: Phone: O� <br /> Time in: 1 .Z S C Time Out: Pa eef Z <br /> EHD 16.24 (2^4 pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br /> 8 <br />