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oP`k"' c SAN JOAQUIN COUN'i r <br />�ENVIRONMENTAL HEALTH DEPARTMENT <br />N: :< <br />600 East Main Street, Stockton, CA 95202-3029 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orq/ehd <br />�IFOR <br />FOOD PROGRAM OFFICIAL. INSPECTION REPORT <br />Name of Facility: <br />S !C / L y <br />�/ <br />Date: <br />5 _Z 7 -OF <br />Address: <br />/ <br />City: <br />Zip Code: <br />i S No7— rAj /Slr►rtart <br />Owner/Operator: <br />IM SS'3�� <br />Su�E�/�� <br />Telephone: <br />(9AG,7�1� <br />Program Element: <br />1 <br />Program Record: NO /G N <br />Inspection Type: <br />Wt 7'12,`c <br />SB180 Posted Yes <br />No <br />Permit Posted ] Yes L No <br />Re -Inspection on or After: <br />Name: S�LEKt N M4S f 61 N <br />Exp. Date: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />l7b T 1A->4�-eR ;Z. Dn'! <br />r <br />r 77Yrs SlN u -i--- <br />w4rviz,, dO <br />i S No7— rAj /Slr►rtart <br />PA> TrC�rDE r kris .R <br />(±4A( O#40eu*R IS <br />Item/LocationTemperature <br />r�6L16 <br />w 38 <br />Item l Location Temperature Item l Location Temperature <br />- - - <br />Food Safety Certification <br />Facility Hot Water <br />Temperature <br />Warewashing <br />— <br />Name: S�LEKt N M4S f 61 N <br />Exp. Date: <br />Hand Sink: <br />/ (40 of <br />Chlorine: ppm <br />Quat. Amm.: ppm <br />Heat: eF <br />Other: 'F <br />arewashing Sink: <br />((/ _ 'F <br />Received By / Title: <br />EH Specialist: <br />Time in: <br />Phone: 41�2C7 Q <br />Time Out: G f Page f) <br />EHD 16.23 (2n4 pg) 11/06/08 V I I V FOOD OR CONTINUATION <br />