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SAN JOAQUIN COUNT r <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> d•.. ;a Telephone:(209) 468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> °cf i=ew+ <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: [ I SMART //0 Date: qv-// <br /> Address: 10�10 Tyzft,/17�1 Ku/V City:S•rDdKror✓ Zip Code: (�5- 21 <br /> Owner/Operator: 'c nM IgA_r N Telephone: N7 (5 <br /> Program Element: !(q Program Record: Inspection Type: <3 LZ 17 n/E <br /> 81 BO Posted xYes 0 No Permit Posted Yes 0 No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> rjt� <br /> /5 iVlc.r k&:s AJ THAAJ SO 3rc/2.c-, SPgeF <br /> I ���''^+ � � <br /> f W LA41 LMI.5fLl / t u& 72 <br /> EF 2✓a T / rti <br /> r r /5 SC'/>ti u r 7a CC- s s - C'— <br /> Item/Location - Temperature Item/Location - Temperature Item Location Temperature <br /> Food Safety Certi •cation Facility Not Water Temperature _ Warew_ashing <br /> Name: Hand Sink: IM <br /> r/� .F Chlorine: PPM eat: .F <br /> Exp.Date: arewashing Sink: .F Ouat.Amm.: PPM Other: .F <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: �v Time Out: "•tel :Q Page 1e <br /> EHD1424 (2bpg) 111M 7 FOOD PROGRAM OIR CONTINUARON <br />