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SAN JOAQUIN COUNTY <br /> :a ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Telephone: (209) 468-3420 Fax: (209)464-0138 Web:www.sigov.org/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: C.7 Date: ,0--- <br /> ddress: l k3 City: . zip Code: G 5331.to <br /> Owner/Operator: Telephone: <br /> Program Element: 1�2� Program Record: 4 +� (_?1[ Inspection Type: 11 ` <br /> SB980 Posted C Yes ❑ Permit Posted 1 G❑`EYes ❑II Re-Inspection on or After: <br /> {)BSItFW tIONS'1 D,,CORRECTIVE ACTIONS` <br /> C C 14o\-A 5 <br /> -�-,r - C� <br /> kr\\j 0� <br /> i- <br /> � -�- -� -� <br /> C,—CA=,< <br /> r <br /> g <br /> i. <br /> itemlLocatinn,:' ...'' ,, " t %: :item Location: Tempera <br /> �@Mj!era t12i'2 - <br /> i, <br /> Food Sof 'rtifica#ion Faciii Fiot water pe '. :x°>... ,. Warewashing <br /> Y tY Tem nature. ,:: mss: <br /> Name: Hand Sink: -F Chlorine: ppm Heat: -F <br /> Exp.Date: arewashing Sink: `F Quat.Amm.: ppm Other: `F <br /> Received By!Title: <br /> EH Specialist: Phone: <br /> Time in: Time Out: �U t� Pag of <br /> EHD 16-24 (2^ pg) 413113 FOOD PROGRAM OR CONTINUATION <br />