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°' 4'A1 cSAN JOAQUIN COUNTY <br /> � � oc <br /> `?a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> • ... _ ; Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.s4gov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility7­7: U .0C15 Date: <br /> Address: '�L r G r City: S Zip <br /> Code- <br /> caner/Operator: Telephone: ()I <br /> Program Element: Program Record: Inspection Type: <br /> B180 Posted ,Yes - No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTWE ACTIONS <br /> Fm A ivy j Ujos hed her- h Q rid and then <br /> f 1 t,y . Fh her 54vo h .S Pro C 1,c e / <br /> -, j1 I (, ic jeJ <br /> IN II n 9l- <br /> t )0 �tiS n Vie; in . hte r CJ <br /> 1 ' tylc bic 'S 62CI 4e f- 1 S <br /> Aw l/ k <br /> O';1 v egX <br /> wT e <br /> 6 kA 5 � �A r' fr , ; Jsr 1.0 iiip <br /> c' <br /> ' , � r,) ¢ t' 1( <br /> 5 rn c 1 3 Or\ 5aJ4 F COV <br /> ©11�•a� a ryl CLie c�. <br /> C1 C,n u fc,(Jo re- <br /> 'J'G >. d. C. / <br /> / by b n/- 4. 0Cr <br /> rs , n . Cc 4Q R <br /> a <br /> h ;z ., <br /> L=�Y <br /> '�.4. i. •. -}. :.d Y." A�i'F"1 " 1 .• :.. Tenapardtte+e MWI`�r Toqaft <br /> "; <br /> Au r. i e 13S ., H ca n <br /> i <br /> Facilfgr Hot Water Toopwahwe Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: d <br /> EH Specialist: Phone: (/ / f/ <br /> ime in: Time Out: (J / d Pag of <br /> EHD 16-23 (21'pg) 07/29/09 FOOD PROGRAM OIR CONTINUATION <br />