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SAN JOAQUIN COUO <br /> �:�cQ•fog <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sioov.org/ehd <br /> tlkdYi w _ <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: %776 747 Date: R -1 (D <br /> ddress: O --- City: Zip Code: <br /> Owner/Operator: [o r " a (( v- Telephone: <br /> Program Element: 0033 Tt. Program cord: /R 0 '53 <br /> Inspection Type: )7 _14O� - <br /> 8180 Posted ❑Yes Rermit Posted es Re-Inspection on or After: /"� <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> YI 16 Lo Lo Lo t.t7 l.0 0I C7 2rl GY-ea <br /> �4— 8 . chs a <br /> S cfo o <br /> _ u-1-S;c1� Q� �12os-f lel a_ Coln a nsz►�� <br /> 4�>_� <br /> Item/Location Temperature Item I Location Temperature <br /> Food Safety Certification V - Facility Hot Water Temperature Warewashing <br /> Name: e-1 ,,r VS✓tand Sink: OD eF hlorine: Ppm eat: eF <br /> Exp.Date: -K, arewashing Sink: of uat.Amm.: Ppm ther: eF <br /> Received By I Title: <br /> EH Specialist: , / /1 , _ L Phone: c53_ , 7 <br /> Time in: !¢. 7 Time Out: / {/X/ Page hof 2 <br /> EHD 1624(2- g) 4013 'T`.! FOOD PROGRAM OIR CONTINUATION <br />