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°'•°...."�" SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> •'. __ 600 East Main Street, Stockton, CA 95202-3029 <br /> c9r/FaRa;P Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sjgov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: /44/065 f2QC-S TV4-' 5 Date: 3_3 <br /> Address: 7 4) Or� 5-7 City: �-��� Zip Code:�5 3 <br /> Owner/Operator: "J14MC-5 Gze 600" <br /> Telephone: 8 ;;eG(� <br /> Program Element: I(rCUZ Program Record: SRUo (� [ ?d Inspection Type: A1FC <br /> SB180 Posted '��Yes-F_;- Permit Posted C- s— No Re-Inspection on or After: ---- <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> /-fi5 rvSfCT�vy /S ETEfZ�'? /lJF l �N17 C5 RgTa It/ D FR/�i <br /> N A l5 c,ft-r <br /> 2, q)651b9AI✓3-T; t7 5-DKO&'�- 5C7rE1_0�-3 (A,1 elV f G13*^--/N r��i �Sr6ti,yT�p <br /> '�9(3G�5 ✓�N D �. 1�-s rG.N i4'7�ZA S�'ts2F}GF SHc`L vES <br /> Ee,S g� l S To Gve)KK avv'5u N�� S. <br /> O fin k 54c-3s 511*7WL)P­-e <br /> S� Dqolu ffPSe 0ouhuar r5 t Noxe-v, <br /> uo D NAN hc,�-R 543� 86kN 31e*>4cvU , PROU 1 Oe P J,,,A &P- -1( ►0,fr1Vtl <br /> C�Gv N62 70 -5r— <br /> d K ',�o /SS e-ec � PFQ►�c r o ,e.l evr r'�t it,lo S�Tin.ts- <br /> [� CIoC7E I� 12 o f��,�. A►�. <br /> Item/Location I Temperature __ Item'/Location Temperature . Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature ,m ;, Warewashing <br /> Name: Hand Sink: �� of Chlorine: ppm Heat: of <br /> Exp.Date: arewashin ink: G of Quat.Amm.: ppm Other: of <br /> Received By/Title: �_ p <br /> EH Specialist: Phone: <br /> CQ8 _yfq <br /> Time in: 10: arm Time Out: I/;l� Page o� <br /> EHD 16-24 (2nd pg) 1112/09 /( FOOD PROGRAM OIR CONTINUATION <br />