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oP4�'" SAN JOAQUIN COUNT <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.orq/ehd <br /> ��RORa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: i �}r� �� �/ Date: 4- 2,` <br /> Address: 7 "1 O 0 A)C1 � /�City: r�/- Zip Code: <br /> Owner/Operator: a� / A r 5 ; Telephone: <br /> Program Element: f 2 Program Record: �' Inspection Type: <br /> C f <br /> SB180 Posted Yes L No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> d 01 C4 ;C, tj <br /> ,Jc> rG d. (f I;an <br /> MIA ; e,- tJ a 01a J c <br /> N I - U V ; 0IC44 Un <br /> d m r o v he r <br /> O C r .i' 0 <br /> 7v Q (nr N ,i V ' ala o n <br /> L � oriq G r r)7 — Ala y',O) A <br /> u >f o <br /> aI 1'i'1i ji r• 1 G m C h)Orinc <br /> I fo - 61t k A2 L' r✓✓l q.!-a 1j a 5 4-E b tArekve �A- P (4wP <br /> 4 0 Soarrpc do <br /> Pro j ;ale S neeLC e^ r O VIP Gr G M Q <br /> Cyrrtcked • <br /> 3 rvv; L W as rtrs Aa; rtrj 4 c d - - <br /> v; c 1.•c <br /> Item/Location Temperature Item/Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.AMM.: ppm Other: of <br /> Received By/Title: /Q <br /> EH Specialist: - Phone: <br /> Time in: 7d <br /> Time Out: Paged of / <br /> EHD 16-24 (2n0 pg) 1/18/12 FOOD PROGRAM OIR CONTINUATION <br />