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P44"" SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> _ 600 East Main Street, Stockton, CA 95202-3029 <br /> . .. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:www.sogov.org/ehd <br /> 4G/jepttt� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: G Date: <br /> Address: VC, <br /> City: 5 x Zip Code: <br /> �G <br /> Owner/Operator: Telephone: I3 _ 9 y <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> c,, ro v - <br /> I n 04r'L/ <br /> a� tt I <br /> q. A A ferU- i I We <br /> 03 1! bu . IU ` y h i w ar) 1 r1 <br /> !i JDe, q r a c,3e I W Q e, <br /> Der dr ; n �ur,cGd��ie <br /> o A bfe IN 4CAlb-le. IF 0 Ve Car d Jbootd <br /> on '1 A 1 ; d Gr c0l 12 er Son o d r ;AX <br /> Fr j Vatg Ct W A f e a „n Pre Co rre c a dq <br /> IP re a C Xj G 1 ; v A,! cc i!e r Repeg <br /> iex I Weer, <br /> OA C004 0 ► a v <br /> i <br /> lkfiih , Cool q 11 tao <br /> C 06 1cc, n ers and jo rovic/ )ads, catrec # 40U�qq <br /> Cleort . n ; 00, 1 <br /> c' 1� uJ r' .� h► <br /> 0 1A Ce Qr.orl� 4o Cft ih s a <br /> WC' (I'mth— d;C, I/ <br /> ktemBAcation " Tp grause Item/Location Temperature kern 1 Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp. Date: g Sink: I of uat.Amm.: ppm Other: of <br /> Received By/Title: - i <br /> EH Specialist: t — Pone: <br /> Time in: Time Out: Page of <br /> 0' 7 G <br /> EHD 16-23 (2nd pg) 07/29/09 FOOD PROGRAM OR CONTINUATION <br />