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aP4ul~ SAN JOAQUIN COUNTY <br /> �•�£off <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> • .., _ ;w Telephone: (209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> q�i)oi. W <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ` — O d nc Date: 19.. <br /> Address: o I u r I City: S 4 K n Zip Code: p� <br /> s plc, U --`` T I <br /> Owner/Operator: �, f uU�15 1►1(- Telephone: 01162Y2 _27/7 <br /> 2y.2 _2 �7 <br /> Program Element: 601 <br /> Program Record: XIS 2 S Inspection Type:fe <br /> - ,n5,nt <br /> B180 Posted L Yes No Permit Posted Yes - No Re-Inspection on or After: <br /> AM <br /> . r' 3.. , `;3+3R1 'Far�ACTKM�1S <br /> 1 vi s ��r✓I Z r f p s } r 0o. 1 c, [_ Ks 11 I,,/a �e v <br /> � h )'C"' We in k <br /> G Imo) a in W c, iA r Gt <br /> I` u ✓ ; dZ @ d, a0 <br /> G I k Y' hG b C4 k' 100 <br /> rcc In in S a rs 01 nil . A <br /> rj Ora t, q Cle <br /> � CAKe rC4f' e � bu5 Id- uA 0 A oo cam <br /> ry I v.e <br /> I <br /> "_s 4 c, r <br /> e p/Iy e C O t foe/ t e l <br /> 04 1; in s <br /> i�s3h;=:Ibex / iqn ►" Ta>A+paatavre <br /> leu #o Im bre f 3 S 1620.F <br /> Food SalTsiy€s i tplan Faaft Hot Water Temperature Warewnl ing <br /> Name: 13 1 , Hand Sink: OF Chlorine: ppm Heat: OF <br /> I <br /> Exp.Date: / arewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialist: — - --- -_ Phone: / //_� <br /> ime in: :� n Time Out: s �` Page/ of <br /> EHD 16-23 (2nd pg) 07/29/09 1 FOOD PROGRAM OIR CONTINUATION <br />