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SAN JOAOUIN COUI <br /> �t '•QG <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.org/ehd <br /> tiFoaa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 'fhan 'S ckfijiSC uc) 1 Date: Cl 1730A to <br /> Address: 2 S , �t bc/radCS City: 5. ��.,,1 Zip Code: <br /> Owner/Operator: YhaM Telephone:l�� 1 _} <br /> Program Element: �2 Program Record: 'FV'6 1(0)©q'A Inspection Type:2 Ve:iR(;Ve' <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> v i c)Iabca-iS CcTT exCeT fi - <br /> 3 c Say_ . YkAMwe Gmd Moimv\ g� omm . N_(100-14 <br /> S vI Le ) LIN`S 4 wosc N S ,eSuo"D TQCA t� <br /> was Sjk,(-(Led Th�� W,M\h Qnd S - .e -iv 11-W .eSk CLAN- \ <br /> .�u�r v�r�r �►e <br /> Item/Location TTemperature Item i Location i Temperature <br /> i <br /> Food Sate ty Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: 'F [Chlorine: ppm Heat: 2F <br /> Exp.Date: arewashing Sink: 'F uat. Amm.: ppm Other: 'F <br /> Received By/Title: <br /> EH Specialist: Phone: d <br /> Time in: 4:-b Time Out: r _1 Page bf <br /> EHD 16-24 (2ndpg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />