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a°'"• SAN JOAQUIN COUNTY <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.orq/ehd <br /> 4LIF8.a�l <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date:MW&4ep, 1 5 <br /> Address: 9,60 I.P^ -t_ 1 City: Zip Code: 06 <br /> OwnerlOperator: !V F� Telephone: <br /> G <br /> Program Element: p Program Recon e'3o,n� Inspection Type: <br /> SB180 Posted Yes V o Permit Posted est' Nvo Re-Inspection on or After: <br /> OBSERVATIONS AND,CORRECTIVE ACTIONS; <br /> V <br /> (1 <br /> - &U ze- q l <br /> - IfemlLocation Temperature. Item 1.L'ocation ;Temperature <br /> Food afety Certification' Facility Hot Water Temperature - - Warewasfifog, <br /> Name: Hand Sink: of Chlorine: PPM Heat: of <br /> Exp.Date: Narewashing Sink: of Quat.Amm.: PPM Other: >F <br /> Received By/Title: <br /> EH Specialist: Phone: <br /> Time in: Time Out: V I t�J Page of <br /> EHD1rr24 (2^ pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />