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aP4�l"• SAN JOAOUIN COUNTY <br />?� ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax. (209) 464-0138 Web: www.sigov.orD/ehd <br />.,�4�iKa•�+`b. <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />J <br />Date: <br />L <br />ddress:3 <br />Ity: <br />�. 2I Code: <br />SZb <br />Owner/Operator: <br />Telephone: <br />Program Element: <br />Program Record: ff 05 10601t <br />Inspection Type: <br />SB180 Posted <br />No <br />Permit Posted 0 -es' No <br />Re -Inspection on or After: <br />O141.2 <br />OBSE ANDCORRECTIV -.AG-J NS <br />r ah <br />44s, 471Yd r <br />Item/Location Temperature <br />Item Location <br />e <br />Food Safety Certification Facility Hot Water Temperature <br />: Warewashing.. <br />Name: <br />Hand Sink: <br />-F <br />IChlorine:PPM <br />Heat: <br />-F <br />Exp. Date: <br />Warewashing Sink: <br />-F <br />Ouat. Amm.: ppm <br />Other: <br />'F <br />Received By/ Title: <br />EH Specialist: <br />Phone: <br />TTime in: <br />Time Out: <br />Page of <br />EHD 16-24 (200 pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />