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P4"Qy..C' SAN JOAQUIN COUN) . <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> J.• 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> CZ.LjF- :P Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.sogov.org/ehd <br /> 90'�N <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: A n A ;,3 4 i h 100 Date: <br /> Address: q G Ten ih Ira City: -Fro t Zip Code: <br /> Owner/Operator:: Telephone: 3 ;2- <br /> _ —73-O.L <br /> Program Element: Program Record: Inspection Type: <br /> vant <br /> S6180 Posted ❑Yes ❑ No Permit Posted ❑Yes ❑No Re-Inspection on or After: <br /> 11 i <br /> I 0 de d ' fo S P P-A c ve o de <br /> /0ar5 Un d r 'bu ; - u <br /> 3 G 3 - a Ale <br /> S c GGrre J r Ntjo <br /> + 5 ♦ ;5 Lo C1n �.^ f\ O . n <br /> 1A 3 C o <br /> j==Temerature -,:Item I Location=2 Temperature Item I Location <br /> 00r 0 , <br /> Food Safety Certification Facility Hot Water Temperature Warewashmg <br /> Name: Hand Sink: Chlorine: Heat: <br /> n G °F ppm °F <br /> Exp.Date: q;.q_ �� arewashing Sink: s+ °F Quat.Amm.: ppm Other: °F <br /> Received By/Title: <br /> EH Specialist: FPhone: <br /> ime in: . Q S Time Out: G v Pag! of <br /> EHD 16-24 (2nd pg) 4/9112 FOOD PROGRAM OIR CONTINUATION <br />