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v <br /> oP4pl" o SAN JOAQUIN COU. _,Y <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 /> °AiFaar <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: CA M1IO r-OOdz. # F111P4 Date: 101 2,6/� <br /> Address: 2 5 A 2 S G bU'�a C�1 U city: � - jt� Zip Code: a6 � <br /> Owner/Operator: Mve4— Cq r r1 I 0 Telephone: i!�1.—t •4 i1, <br /> Program Element: t('0-_) _ Program Record: 01535(,( Inspection Type: <br /> SB180 Posted Yes No ✓ro Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS. <br /> a4111*0 \.f 1CA4 rA&I7 CMSi e . <br /> rann 0r Go tlnz cis e c+ ` t4 <br /> fill v G iS C3i1 <br /> ►� �S .Ma�_inutriivS afi 'Ler `hu-1- <br /> (� f\o vii - DNC�C(At)InOMZ ro6cku 1 well <br /> o d nn SThat Qvz rpodz of <br /> 1'G cri limit , <br /> tn° S m0- Ufi i <br /> Mme <br /> ttem/Location Temperature Item/Location Temperature <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: 'F Chlorine: ppm Heat: 'F <br /> Exp.Date: Warewashing Sink: 'FID uat. Amm.: ppm ther: "F <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> diJ"1' -tvU• � <br /> Time in: j2:2 JTime Out: .Z : Paget of <br /> 5 <br /> EHD 124 (2b pg) 4W3 FOOD PROGRAM OIR CONTINUATION <br />