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SAN JOAQUIN COUNTY <br /> ZA 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 /> �lkd'i+ <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: smAst4 Date: .L S <br /> ddress: City: Zip Code: qr7 <br /> Owner/Operator: Telephone: "1 <br /> Program Element: Program Record: -0� LxOi Inspection Type: <br /> SB180 Posted Yes 1119 <br /> Permit Posted No v Re-Inspection on or After: <br /> PP AND'WkRECT.NEACTIONS• <br /> u1 s 3 <br /> rAM <br /> iS <br /> U a <br /> o <br /> c t^ <br /> f all <br /> I <br /> - - - - Item/Location Temperature. - Item/'Locatiom - -FTeniperatore' <br /> Food'.Safety Certification _ _ _ Fay'ility H'ot Water Te5_n_pera_t_ure _ Warewastii�g _ <br /> Name: Hand Sink: 'F Chlorine: PPM Heat: "F <br /> Exp.Date: arewashing Sink: OF r <br /> uat.Amm.: PPM Other: 'F <br /> Received By I Title: �n <br /> EH Specialist: Phone: Zt�O _ 7n� <br /> Time in: Time Out: Lam/ Page of <br /> EHD 16-24 (20 pg) 413113 FOOD PROGRAM OR CONTINUATION <br />