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Name: \2-Okul co\ vcA_i 0 <br />‘‘ / Exp. Date: °F arewashing Sink: <br />0-0 <br />';() OcNc. DAvie. <br />(A` ‘ccut, 1).-ocm‘\-- <br />oi 0.0s <br />A--? pc e nk- <br />- 3414k - <br />c) Time Out: Page (of) Time in: <br />Received By / Title: <br />EH Specialist: <br />C. <br />Facility Hot Water Temperature <br />Hand Sink: t Lt.; .F Chlorine: <br />Warewashing <br />PPm Heat: <br />PPm 1Other: Quat. Amm.: <br />Item/Location <br />Or <br />Temperature <br />f- <br />Temperature r <br />Item / Location <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orgiehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: t:, ‘ IQ 0 1 conc., CAu c 0 z--, 1:1C11 Lac\ C., -_--, Date: <br />Address: S CO I-- -Th .C—A- City: ‘ ( Zip Code: Ci '2.) s 1- <br />Owner/Operator: (Au \ at \ , 0 I 4c ,___, Telephone: 112 <br />Program Element: I - Program Record: ç .-7.- Inspection Inspection Type: co-/-14,1 rt...Thci---, <br />SB180 Posted r Yes , Rermit Posted r. Yes - I Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />k,‘ -fl €' 4 c-v\s-5.0 <br /> <br />FP00(-142 a '-c-c9A- NNCA"VeA (CA? , <br /> <br />vv_ov \ay. cc) cA1\ eit-AVVA.te <br /> <br />END 16-24 (2^' pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION