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SAN JOAQUIN COUNTY <br /> Z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> �q•.., .•.�;�P Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> �1 FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ) /W GIjuC Ccs It, f Date: -;z <br /> Address: ('414 <br /> / ^ City: a ,CZ f� Zip Code: <br /> Owner/Operator: J ` `.1 vvK- Telephone: <br /> Program Element: U y Z Program Record: ,+�SZ /`„ Inspection Type: N I'Ik L e G�% <br /> V61-80 Posted Yes E No Permit Posted Yes ❑ No I"(/ Re-Inspection on or After: I/ <br /> OBS RVATIONS AND CORRECTIVE ACTIONS <br /> Gt1z A lam✓ ��n <br /> of lanA t✓ a <br /> ✓i0 19h OM 04ft a al <br /> �s <br /> ` 98 k . lk . J° <br /> . 1 r <br /> KwVLocation T@mperature Item!Location ' Temperature Item I Location Temperature <br /> ' <br /> Food Safety Certification Facility Hot Water Temperature - Warewashing <br /> Name: i't Hand Sin of 'iChlorine: ppm Heat: of <br /> Exp.Date: �}�,v ](/ -2 arewashing Sink: of rQuat.Amm.: ppm Other: of <br /> Received By/Title: I d <br /> EH Specialist: Phone: <br /> Time in Time Out: Page f <br /> EHD 16-23 (2n1 pg) 07/29/09 FOOD PROGRAM OIR CONTINUATION <br />