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SAN JOAQUIN COUNTY <br /> X ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> • �4... `�,...;P Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> ��FdaN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: !�� d� 7717-77T Date: p <br /> Address: 1 / ✓ City: / Zip Code: <br /> Owner/Operator: w'l�/In., Telephone: <br /> I� <br /> Program Element: -� Program Record: 7 /� Inspection Type: we <br /> B180 Posted � Yes -i No Permit Posted Yes ❑ No [ Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 1 C. Yyt <br /> 1-�zr h v�*G� / J l ore <br /> -�' I S �� ��k'1 S0i'vill Xe i d C Gtt <br /> hiowt <br /> i <br /> �- � <br /> h �� l-��y�J. lSyJ� <br /> ��T,�r/ �� �- G�iy►Mi� /r�I t�, - <br /> ItemA ocation Temperature Item J Location,' Temperature Item I 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: <br /> EH Specialist: hone: <br /> l <br /> Time Time Out: Page of <br /> EHD 16-23 (2o°pg) 07/29/09 ( FOOD PROGRAM OR CONTINUATION <br />