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SAN JOAQUIN COUN I Y <br /> N 'Z< ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> �i6y- 2sb z <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: abAi d 10 SC, V Date: 3 d <br /> Address: . U/I s K City: f Zip Code: 2 G <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: Inspection Type: <br /> Rom >#i>1 <br /> SB180 Posted ❑Yes ❑ No Permit Posted ❑Yes ❑ No Re-Inspection on or After: <br /> AWW �r ,.. 2BSERVATIONS AND CORRECTIVE ACTIONS <br /> jV C) i u v-)) -- — - <br /> pp B � �►tCe 6 YyICIA <br /> ¢ �-t au j b ONd > okea n <br /> J!L iUC tie /' rP jr-o (10crxd <br /> .._ <br /> ltemll acaii ` Tem erature item I Location Temperature Item I Location Temlaerature <br /> o <br /> Facility Hot Water„TempPeq?tupq., . Warewashmg n�� <br /> Name: Hand Sink: of hlonne: !Heat: <br /> eat: <br /> of <br /> Exp.Date: arewashing Sink: 2c) of uat.Amm.: ppm (Other: - - �F <br /> Received By I Title <br /> EH Specialist: Phone: <br /> Time in: Time Out: `7 b Page of <br /> EHD 16.24 (2nd pg) 1112/09 FOOD PROGRAM OIR CONTINUATION <br />