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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> �q•. . .&.:;4 Telephone:(209) 468-3420 Fax: (209)464-0138 Web:www.sjoov.org/ehd <br /> tlddd� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: R Rf nSV 'n 'S !A ✓4'S S Date: <br /> Address: '730 <br /> C r�Q City: L_ Zip Code: <br /> Owner/Operator: J (n n n �SGonTZeoia one: <br /> Program Element: /�� �(O rogram Record: O C) Inspection Type: /75U/-/.y <br /> SB180 Posted 0 es o Permit Posted 0 Yes 0 No Re-inspection an or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS ' <br /> Nc' 01 <br /> VJ 1 L Yt 1 P <br /> t o 4i -4e rp -e d b i <br /> Ma ,' <br /> a C was e h <br /> -e r <br /> T6 a SD r <br /> or'nr <br /> D <br /> W-Po ct a.L 1 °F Oy-' lzvIPr <br /> 0 <br /> C ( r e <br /> ItemlLocation ' . � Temperature ° ps;--Item!Loiatioo ' A ' . Temperature :R '=y 'dtemlLocation Temperatuie' <br /> r czowr ar <br /> Food Safety Certification _ Facility Hot Water Temperature - - Warewashing _ <br /> Name: Hand Sink: /g7 'F hlorine: PPM Heat: eF <br /> Exp.Date: arewashing Sink: 'F r <br /> uat.Amm.: PPM r <br /> ther: eF <br /> Received By I Title: <br /> EH Specialist: hone: <br /> Time in: •3 Time Out: 6 ; Pagel of <br /> EHD1G24(21°pg) 11/M O FOOD PROGRAM OIR CONTINUATION <br />