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*ro <br /> SAN JOAQUIN COUNTY <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 /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: S 2 b Date: <br /> I <br /> Address: City:-- (Cly Zip Code:o <br /> Owner/Operator: Telephone: <br /> Program Element: ` b Program Record: S, n ` Inspection Type: <br /> B180 Posted ❑Yes ❑ Rermit Posted E.Yes ❑t Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> AAk i, <br /> 2 4 0 M J� <br /> Name: 7arewashing <br /> Sink: of Chlorine: ppm Heat: i of <br /> Exp. Date: Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: S\ �, `,,�` 1 \ _, \ \ <br /> EH Specialist: . Phone: _\b <br /> Time in: Time Out: JJ Page of <br /> 1 <br /> =HD 16-24(21 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br /> Q541�5S <br />