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SAN JOAQUIN COUN r <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />-_ 600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sogov.org/ehd <br />L/Foca <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />rr <br />Date: .3 SO 1 t <br />Address: <br />5-15 ��� � City: <br />r <br />Zip Code: 475d.0,3J�J <br />Owner/Operator: <br />3 ! . <br />I ne: <br />Program Element: <br />UI� Program Record: J ���^� <br />Inspection Type: <br />►`(J <br />es <br />S131 80 Posted ❑ Yes/ <br />No Permit Posted es ❑ No <br />Re -Inspection on or After: <br />EHD 16-24 (2"" pg) 11/2/09 FOOD PROGRAM OIR CONTINUATION <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />3 ! . <br />S <br />/ l <br />0j71j, <br />, <br />!/- <br />Item/Location <br />Temperature <br />Item I Location <br />Temperature <br />Item / Location <br />Temperature <br />f. <br />/a <br />Food Safety Certification <br />Facility Hot Water Temperature <br />Warewashing <br />Name: <br />Hand Sink: <br />f <br />Chlorine: ppm <br />Heat: 'F <br />Exp. Date: <br />Warewashin§ Sink:-11,5—of <br />Quat. Amm.: ppm <br />Other: of <br />Received By/ Title: <br />EH Specialist: <br />Phone: , / <br />Time in: I <br />V <br />Time(hit: PageZof <br />EHD 16-24 (2"" pg) 11/2/09 FOOD PROGRAM OIR CONTINUATION <br />