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SAN JOAQUIN COI: Y <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �..,^. • .. P Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sioov.org/ehd <br /> �rcdA`' <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 1S I ' LY" rt Date: <br /> Address: O �' rn-ta city: �.�cr--oh zip coda: <br /> Owner/Operator: Fv-o-vl C:i 5 C_a (-7 ri ' A I Von Telephone: <br /> Program Element: I&o 'JI oto (Program Record: SR OO ') 1 -6(7O Inspection Type: <br /> SBI80 Posted Yes No Permit Posted Yes No Re-Inspection on or After:S�t � Nb 1 - <br /> V�i,✓► <br /> r1�f5—��/thi•cls heive p_L_d D_u)Lwv ►' <br /> natx . a.�n-f 0ver <br /> ri y-n W " Fra-n c f' .w -Uri a 1 va " . Co r rt°r-4- be, I we a.K— <br /> SoraL,L L"-K 0,16g V- �'.'Al-C V-% 5.I �C R*Tno� b lwo. <br /> W o o v O v2- C c!.0h4--s <br /> w-o <br /> p "K> n l'ln' 6.ee at ( 1 - w. <br /> 0, K +o L �_U Z_]?x r rw� on c4- G &s po6s'a . ro Ya M <br /> ���� r �,�ItemMcaUdn�� -aa -�4„ v7emperafural� � r x..�� :Item/,Location - �-� �STeitiperature; <br /> -kar-n Tables 167 <br /> " . <br /> 4r. �:��r�F,00d;SaletyCerhfi atiori �,E. ��Faahty HotEWaterTemperature; _ '•:�-t,���r�;-q;,w`"�'� W_arewashin-w <br /> Name: rr nG1 5 C•.o U 'IA I VGt and Sink: �-I S� OF O Kne/ttI too Ppm -eat: of <br /> Exp.Date: I 1 _I are�gashing Sink: OF uat.Amm.: PPM Other: OF <br /> Received By/Title,• 33 <br /> EHSpecialist: ^ Phone: L <br /> Time in: Q • B Time Out: t7q!/0 <br /> O Page of <br /> END 1624 (2°Dg)4W3 7 FOOD PROGRAM OR CONTINUATION <br />