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aP44!IH SAN .JOAQUIN COUNTY <br />? ENVIRONMENTAL HEALTH DEPAR rMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />��.... ..... a.. Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.org/ehd <br />GIFORrr <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: './ti15 et - N - clo seq fvo -o-rft_.`.�,'� <br />Date: cU,•� �� <br />Address: 2240 S V009,%" City: <br />S}IiL j--tz rj Zip Code: Q 5 <br />Owner/Operator: _ h . <br />Telephone: 4-- 16+4 <br />Program Element: �•1 Program Record:tt ,�5 qa Inspection Type:�c) e r <br />SB180 Posted ❑ Yes D Permit Posted ❑ Yes D I <br />Re -Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />Ul t -w, sc 0- q S1 4 C1 U Ii <br />W -0 -tae c,+ttcT-irle AeSk "S- <br />nvicu 1he -Aym,.rt(, TYAme 1 S <br />c)T-\ b0"1}1 4� S OF <br />in (00 aa4S <br />35 FFOv�Cke a �--Ood M fg ctna <br />s C rhi-ice CAtd <br />a -r- c borowx Curd i&r- all <br />,eS vo'twv) so dace <br />cctn1%0�- rssue- RxjAo- vrtt=\ Cu*MM-%�-�•Vq <br />L2+1-� S ,2P�M <br />•2 C.eaved . <br />A 2u3 <br />xature � <br />3 yr -Turbo 6q, r 41 F <br />Food Safety Ce <br />Name. Hand Sink: t UC) <br />Exp. Date: Warewashing Sink: (2d <br />Item I Location �""` Temperature <br />'. 'Warewashing- ;. <br />eF hlorine: - ppin Heat:- -F <br />of Mat. Amr -- pP�n Other: aF <br />Received By /Title: <br />EH Specialist: <br />Phone: <br />"T <br />Time in: : c) c6I <br />Time Out: Cl : 11 Page I of <br />EHD 16-24 (2ntl pg) 413/13 FOOD PROGRAM OR CONTINUATION <br />