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a°'"• SAN JOAQUIN COUN . . <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> d[lkiS"a? <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: .LA)tf j. j n <br /> Date: 6- J ,?— <br /> Address: <br /> ddress: I Ud �5 A 4 d e'- C'ry' .L rn r eyl c zip Code: g 45.5 I <br /> n <br /> Owner/Operator: PGUI $ u1tQ� a !'1'Itl1�'� r:LG Telephone: r9,25 - 22- /fr/2 <br /> r SC ;O •I� c <br /> Program Element: t7/ Q 3 Program Record: S D G a 2 17S' Inspection Type: COn S u /•/cr l <br /> 8180 Posted ❑Yes 0 Permit Posted D Yes Of Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> c $ V 6 rb <br /> y; s 8 U K <br /> U J ; cicl I ;on S <br /> NU •Ie : U no bit4-0 St If 6 /os; n or ' <br /> r rP-5 ho Ve A/rn <br /> 633 - Or, ly ee ad Pre -muse bteah <br /> 195 <br /> Item/Location Temperature Item I Location Temperature <br /> 3 . <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: u it Pi /6 ,,and Sink: `F hlorine: ppm eat: "F <br /> C;dJJo <br /> Exp.Date: D / 3 , /G arewashing Sink: / OF uat.Amm.: ppm ther: "F <br /> Received By/Title: <br /> EH Specialist: Phone: 6 -J 16 y <br /> Time in: 0 � y Time Out: . Page/of <br /> EHD 1624 (2n°pg) 413/13 0 FOOD PROGRAM OR CONTINUATION <br />