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o °we SAN JOAQUIN COUN <br /> Zj ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209) 464-0138 Web:vvvvw.sigov.org/ehd <br /> L(FpR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: S o L 1 0 Z n Date: fir/V ( (� <br /> Address: 4 9— S CU l 1 �n(C,, City: ��-�uL Nz-Tn Zip Code: <br /> Owner/Operator: �, GbOf'Co Pmd r� Telephone: <br /> Program Element: 1 V Program Record: U {� �u LL } 2 Inspection Type: �(msN t�►„�, U� <br /> SB180 Posted ❑Yes ❑ Rermit Posted I` ❑Yes ❑ 1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS X <br /> Ll tiCX 4 0 -15C1 <br /> (P Pbvw i4c'W 2 0-V- Uvvrlvx can i?i h SIIck S C+ ve'h-1c 1.e- <br /> �. Li fiS o 6A- wo—v�_ pno jb n.eed ccrref-'�' *(unnok 11'SVIzR"4m.1�- <br /> vh-ht \ af:e bxeo)k <br /> 9 r10 SCcx- anO hGjrds,rn\L v,cdS �Aoc y-ec . C."fe c can S,-I-e- <br /> ® M-w k ce CA -cY.esh w cAe-f GAh vca s -e WG- e-T- C u <br /> 5 scrn�e s�1•�e�� r�� -ry �2 r ��cic.�-d <br /> S n�- %5 c1 ac <br /> '�WcA 'rwc�d Mura `S a �� U� ccs S <br /> arg VGCXi n Q5 YV 0v ,_e. a ril- aid t- <br /> C �0 �► C� ' WO_4? CAnQX's name �n 1�SIh SidQS �r�2 <br /> a -Ffesh l�Uv '�uuC,� MAonCJV ` 5 ,.T::-o00 �Vh lir Curd CM <br /> ,AC A �nl A ��n S wcn 1 Fix fivcki ►h�C G�2 nes n9 <br /> b-.A 1h2 c�it:l n s�r-e�n r�-r �h e c,1 r1v,�r s 51r,� nes ►' <br /> �t(,Y- �- 52 GW npil" S hc,�rn.rz 6fi G�1 U WC'c�-. 51 <br /> 3 (!v k ck G0 V91T14 01 C V-4 \fN h01 n . P 1 1-T <br /> eS Cs.Al'mb I A -r rid t-- ULf coo &,-s� r,,0e <br /> C ►�� SSGI o� all fiS w . rix five teat ail Gl�a�� <br /> v CGT) Gi t Y Q CL VIP-0 v�G -- <br /> b ti UU On on iz46Li cv)b 6clel* d <br /> Amra PjT�1W� '1'bCA, 11 Q�C�S �e Gt <br /> ItemlLocation Temperature Item 1 Location Temperature <br /> v C)i.2I .S I` - C CAK10i <br /> 14e r\4 1-t�6�S 1 oOF )rul 0.C--;rfi r s <br /> cum: i (-wick c�, of <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name:___-__`_� 'Pude — Hand Sink:-- - i U(, of Chlorine:--��CII I ppm Heat: of <br /> Exp.Date: �� arewashing Sink: i�7 C of Quat.Amm.: ppm Other: of <br /> Received By/ <br /> EH Specialist: Phone: 0cf rte-„ :2 <br /> Time in: Time Out: 11 A P lJ Page +of <br /> EHD 16-24 (2nd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION <br />