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Wly.•.poG SAN JOAQUIN COUNTY <br /> zENVIRONMENTAL HEALTH DEPARTMENT <br /> a: .a <br /> '. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: R IIJAJ !t ` Date: <br /> Address: City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: I Program ecord: !7 Inspection Type: �- <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Vl ' <br /> Ale cow <br /> L , <br /> I <br /> V! <br /> Item/Location Temperature Item/Location Temperature <br /> 6F6 a'nZ d <br /> dZV CI <br /> u �/� <br /> ti <br /> Food Safety Certification Facility Ho_t Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: u� ppm Heat: �F <br /> Exp.Date: (Z ZlJ ir arewashing Sink. 20 'F Quat.Amm.: D ppm Other: _ 'F <br /> Received By/Title: <br /> EH Specialist: Phone: COti <br /> Time in: It Time Out: Pagel of <br /> EHD 16-24 (211 pg) 413/13 FOOD PROGRAM OIR CONTINUATION <br />