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SAN JOAQUIN 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.s'ciov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility:Date: <br />Z kZL� 2C9 2�2 <br />1 _3 _r '_ <br />C57, E2 0 <br />Address: <br />I 's 3 zk—) <br />Owner/Operator: 4S. f� P" <br />Telephone: <br />Program Element: I b52_ <br />Program Record: <br />Inspection Type: <br />SBI80 Posted Yes No <br />Permit Posted Yes No <br />Re -inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIO <br />r <br />NJ <br />40" <br />&--t C, <br />Item/Location <br />Item I Location <br />Temperature <br />Food Safety Certification Facility. Hot Water Temperature <br />Warewashing <br />Name, <br />Hand Sink: <br />Chlorine: <br />FE PPM <br />Heat: of <br />�E,p Date: <br />Ware% ashing Sink: ,"___�F <br />uat. Amm.: Ppm <br />Other: =F <br />Received By/ Title: <br />EHSpecialist <br />1 <br />P hdne. <br />Time in: <br />Time Out: k C): 3C)04V_' Page'of <br />EHD 16-24 (2m pg) 413113 FOOD PROGRAM OIR CONTINUATION <br />