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SAN JOAQUIN COUNTY r 0 PU <br /> a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax:(209)464-0138 Web:vvww.smqov.org/ehd <br /> ?CfFOR? <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: v { � Date: <br /> Address: 1��3 City: ,\ jy Zip Code: q � � <br /> wnerloperator: rr,1] ` \ � `` V V VTr� Telephone: r 2 <br /> Program Element: �U Z Program ecord: tQ} � Inspection Type: <br /> B180 Posted �U Yes C Rer-m-it Posted C Yes ❑ I - Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> — — <br /> ���1���—._`may>eJ�-/).�P. .� -_�"�_�'�}..�'• 'fes. <br /> 04 <br /> AA- <br /> EA 5kz <br /> Itemfl ocatron 1�mperature ;, Item l Location E Temperature <br /> Food Safety Certification Facility Hot Water Temperature <br /> a ,..��_._...-_... .._ ...._. ..� _ I _ _ Ulfare�stung <br /> Name: Hand Sink; of hlorine: m m ppm Heat: F <br /> Exp. Warewashing Sink: of uat.Amm.: ppm ther of <br /> Received By!Title: <br /> EH Specialist: � - Phone: <br /> b ime in: Time Dut Lt ^ Page of <br /> LU 15-24 {2-pg; 4013 k <br /> FOOD PROGRAM OR CONTINUATION <br />