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SAN .JOAQUIN COU14 I-Y <br /> Zr ? ENVIRONMENTAL HEALTH DEPARTMENT <br /> M' <br /> & ' 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �a..•. .•...;a Telephone: (209)468-3420 Fax: (209)464-0138 Web:www.s'gov.org/ehd <br /> [IFdN� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: S G � Date: ?J/i ( (o <br /> Address: i 2p S . Cut I G Olry' J'�"�Cr1L '�71T� Zip Code: G GJ20S <br /> Owner/Operator: R-t G be-f-tD R-Dd FCk Telephone: <br /> Program Element: t b O 2 V Program Record: 00 _-1- Z� 2 Inspection Type: <br /> SB180 Posted O Yes D Rermit Posted +� O Yes O 1 ' Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> ?R v1 14c'We 0-1� CNvnp/f Ufa �71 S,G>0_- W v.2 iLt_ <br /> Li 1 S o Cyt- war k- nnQ ib need cw2r �, A c un oo� i SSu e z'T M•I} <br /> vr\trt " •vs, G1r..e IFAxP-0Ik <br /> 3 KO Cooj> onO 1,G1rdrnv wct& �Aoc*ec . c"rceC c`R SI}1- <br /> FR wiG� C{ Gln W(QS�e vYGO-e-r <br /> 5 SUM L ScT.ePTS Pct -1z> �e r �lG,r-eG� <br /> Wo y nt t5 600C McirA `S Ord V00, i\zmdU-17 eadS <br /> a�e �CACxin% �jzoviCW, C1 v-ir5 ` Old it <br /> GA14npwlr ' name a WVh sidPS <br /> C( fresh v--a1 e> vwv'i61e voca Vona 1 ` S , f�ooCF A\rAh lP-r Card 611 <br /> S1a2 4 onl 11 rtA t` -,S wart'-r ra . Fix i-z A a✓ 'Iha'oe Gre ms&og <br /> t <br /> �u rp tb 'I65 ® Th2 cbul n SGZr at the �, ry �r^S Side heV. 'Jr; <br /> v taN 55OSrom <br /> GAS <br /> CC-1-Ity-6 l=o4 kkr' , a r cao G/r Site <br /> 1LC (D-iA& GII fis WC1f-� . rix �bcmv A2 V" all G1rzi« <br /> 1 qC CAn 1z'6u 3 r n�- VD�-ll Obi <br /> b ti -ort on r ru O)LI radeon 0 S in ci <br /> I�PrmwL 'f::GCA I.I ,QedS TO 6.e Clonw ct <br /> O <br /> Lro AO � re C aeo Cpodc C�1r10 lac <br /> Item/Location Temperature - Item I Location Temperature <br /> IP-kACG�- C061"-S 4' )of- -)F- CUhnv4- ISSV�L eAz4M <br /> ,tet fiz+b�S l+ i S <br /> cctri'•• i RGNi si a <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: t1 y2l Hand Sink: I rJ 0 eF hlorine: -PYGI I PPM Heat: eF <br /> < ti <br /> Exp.Date: .'4-ACA r <br /> arewashing Sink: 12U `F Quat.Amm.: PPM Other: 'F <br /> Received By/ e: 0(r <br /> EH Specialist: Phone: <br /> Time in: Time Out: tt: 5 Page of <br /> q 95 <br /> EHD 16-24 (2n°pill 4013 FOOD PROGRAM OIR CONTINUATION <br />