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_a"'" SAN JOAQUIN COUNTY <br /> ...... e <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> • oq.. t =.a�P. Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> ��FOR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: W O p k stere Date: 9- 3 -16) <br /> Address: 3(9 P/ - Y - City: 5;4vG� Zip Code: s <br /> Owner/Operator: !7 �S Telephone:0, A�0 p 60 . e 77__�i O _ 75, <br /> Program Element: / I C Z Program Record: f� 6-7-ZZ Inspection Type: lee <br /> SBI 80 Posted Yes X No Permit Posted KYes ❑No Re-Inspection on or After: <br /> �. 1$'0 0 tau ly da p& -S6 D <br /> - oCA„ 'e M�WGod F.¢.eS <br /> prewashin <br /> Name: N and Sink: of Chlorine: ppm Heat: aF <br /> Exp.Date: arewashing Sink: >F Quat.Amm.: ppm Other: op <br /> Received By/Title: <br /> EH Specialist: P one: <br /> Time in- SDA Time Out: _ 3S� Page of <br /> EHD 16-24(2^d pg)'11/2/09 FOOD PROGRAM OR CONTINUATION <br />