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a�Aui"• SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> .c4ClFeni;,'�. Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.s'gov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: , ,� - - - - Date: <br /> Address: (1 6 City: Zip Code: <br /> Owner/Operator: �. Telephone: <br /> Program Element: Program ecord: Inspection Type: <br /> B180 Posted Yea No Permit Posted f Yes), No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> U 1;9 11 U II � <br /> nruto cc. 612t7&&rLj2-d <br /> -T-temperature '- 1 e � " oC - '•" Tempe re <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: "F Chlorine: ppm Heat: aF <br /> Exp.Date: arewashing Sink: 'F uat.Amm.: ppm Other: 'F <br /> Received By/Title: b-04 <br /> /l A <br /> EH Specialist: AXZ4 •'1 Phone: CA— ((P— <br /> ima in: Time Out: �l Pagj of <br /> EHO 7624 (2-pg) 4/313 FOOD PROGRAM OF CONTINUATION <br />