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SAN JOAQUIN COUNTY <br /> z� ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> • .. ;P Telephone: (209)468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: vss p� (Z�S S4° Date: 9—S^/C:�' <br /> Address: -S2-00 City: - Zip Code: C?.5.3, <br /> Owner/Operator: S !�a Telephone: 832_G/5-e <br /> Program Element: /( /S Program Record: y/3 Inspection Type: <br /> SB180 Posted Yes I 1 No Permit Posted KYes n No Re-Inspection on or After: <br /> OBSERVATIONS AND,CORRECTIVE ACTIONS <br /> j �K wi4PC- Nc-ytsE H9 -oNF <br /> s�tiz- <br /> Me <br /> � <br /> 16 I— C.9P a-&09RA a <br /> perature. <br /> _77 . <br /> ility Hot Water Tempe Warewashingi <br /> Name: Hand Sink: °F Chlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink:�-- 'F Quat.Amm.: ppm Other. 'F <br /> I <br /> Received By/Title: <br /> EH Specialist: — Phone: <br /> Time in. Time Out: ` )"U�Ocr Pageff <br /> EHD 16-24 (2n°pg) 11/2/09 FOOD PROGRAM OIR CONTINUATION <br />