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SAN JOAQUIN COUNTY <br /> . ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> C'q•..,5 ,.�;P• Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.s4qov.org/ehd <br /> ��Foa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: AT7 <br /> Date: Z -7 <br /> Address: S City: —LATk k,6 AIN Zip Code: COW <br /> Owner/Operator: Telephone: 11 U <br /> Program Element: Program Record: Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes o Re-inspection on or After: <br /> � - .,; ��t �•»��—�� � a sem,ru+�sr€��^ r �'` <br /> �I � SF� ONSDORIEG�TIY�AC�TONS # �' - -- <br /> - r <br /> h i <br /> ai— <br /> S C C owl <br /> o r <br /> w 040 <br /> Item/Location Temperature_ " Item l LocationTemperature <br /> Food Safety.Certification Facility Hot Water Temperature Warewashing` <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title:If _ - , J <br /> tfll <br /> EH Specialist: / Phone: '^'�— '� <br /> � W 1 <br /> Time in: Time Out: Page of <br /> EHD 16-24 (2"d pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />