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oeR"•n•.� SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />r4��Fda� p • Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.s4gov.ora/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: • <br />is C i !-Q Ar C <br />S 2 2 Date: <br />Address: S <br />\') ; \ <br />City: Zip Code: <br />Owner/Operator: <br />Telephone: <br />Program Element: `�3S <br />Program Record: �. <br />Inspection Type: r -(Q_ <br />SB180 Posted Yes No <br />Permit Posted Yes No <br />Re -Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />4 <br />2 Ale <br />S 12 <br />m/Locationmperature Item / Location <br />2` O _ <br />Foonety ci cat t�hdility Hot tura arewashin <br />Name: ` UHand Sink: =F hlorine: ppmHeat: =F <br />\^Exp. Date: 2 arewashing Sink: �11N =F Ouai. AMM.: ppm Other: =F <br />Received By /Title: <br />� <br />EH Specialist: <br />KE <br />. <br />Phone: <br />V <br />Ime In: ' <br />Time Out: Q' Page of <br />FOODEHD 1624 (2d p9) 4013 �,,.. <br />