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oPQurN c SAN JOAQUIN COUN9 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.segov.org/ehd <br /> L�FORN <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: I CA n en P Date: 1 -10-13 <br /> Address: ;1 f , 'r(,n 1 City: I rC Zip Code: <br /> Owner/Operator: i J T (' Telephone: 7 <br /> hcmuW: S�iy- s � 4s <br /> Program Element: ( Program Record: U 7 ,J Inspection Type: <br /> SB180 Posted a Yes ❑ No Permit Posted Yes No Re-Inspection on or After: 1� <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> V ; Io } ; an ; <br /> Item/Location Temperature Item/Location Temperature Item!Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature 5 JE�tz r r• Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: F <br /> Exp.Date: Warewashing Sink: of Ouat. Amm.: ppm Other: of <br /> Received By/Title <br /> EH Specialist: — Phone: <br /> Time in: v O Time Out: Page of d <br /> EHD 16-24 (2nd pg) 4/9/12 FOOD PROGRAM OIR CONTINUATION <br />