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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.s'gov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 1(oN To'X N U Date: 11 Iu <br /> Address: L-r Cold /\N Pr City: Si..of � Zip Code: <br /> Owner/Operator: Telephone: r <br /> Program Element: lwU Program Record: C O (JD 42551k Inspection Type: cti n.1—. <br /> 8180 Posted ❑Yes ❑ Rennit Posted byes of Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> Col nt iP-N C+ 1(. CY-12i n Ft t Oro <br /> do no-v ve a puce tv ub-L Yht, refi-wm . <br /> - O�JfIU' S"�Gta-eS �( P 1"h R- h M J �'2S'►�I�N <br /> R sN-Roo M v of .h CGIb1AN -Pz. RSA ncA op Si4f <br /> -ilk cAA-1- U (Z M V GV f COtiUN tUQ)-A <br /> on )min G 0- -tb t Aq> <br /> Item/Location Temperature Item I Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: >F hlorine: ppm Heat: of <br /> Exp.Date: arewashing Sink: of Quat.Amm.: ppm Other: eF <br /> Received By I Title: <br /> EH Specialist: Phone: [1 (9 <br /> Time in: ^ ;,� Time Out: .7..41 T Page of <br /> EHD1fi+24 (2i0pgg)) 0113 v FOOD PROGRAM OF CONTINUATION <br />