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opAHIN, F SAN JOAQUIN COUNTY <br />?� ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />�4crbeNN;4 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.oro/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: 7 Ll 7e-7,, <br />Date: <br />Address: i7'5` 9 <br />J <br />L City: L <br />'L <br />Zip Code: <br />Owner/Operator: <br />Telephone: <br />Program Element: t b Program Record: <br />Inspection Type: <br />u <br />56180 Posted Yes No Permit Posted <br />Yes No Re -Inspection on or After: (� �. ?✓� -� <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />e-4 1,00F <br />K d a� <br />I urs v a /7 />ylz�n <br />47- <br />bx ess_' . <br />'- ze'A-F" <br />W, G kov, .1 e <br />VIL�y <br />11 u-&�d 'KL'/ZzAP /�"e<sl <br />hr ohz . <br />�' ef fv <br />—S <br />; <br />4 <br />pAi rlu <br />OH <br />- <br />;-a- <br />n <br />41 <br />C S <br />� _ <br />44,, --P <br />Gr <br />Item/Location `: _., °n <br />Temperature <br />Item / Location <br />Temperature <br />C1 <br />fir— <br />c�- ;v <br />Yo f <br />ri U <br />y <br />Qazooq 's <br />3 F <br />s : Lv <br />r �v�T <br />Is. <br />FoodrSatety CeRiflo tion <br />Facility Hot Water Temperature <br />"1Nerewas ting <br />Name: <br />Hand Sink: 'F Chlorine: <br />ppm Heat: <br />"F <br />Exp. Dale:arewashing <br />Sink: "F uaL Amm.: <br />ppm ther: <br />of <br />Recelved By/ Title: i 11-5 lu S <br />EH Specialist:. W �-,A <br />r �>� <br />Phone: <br />Ime In: i D 4 M <br />Time Out: I a <br />V1 <br />Page of -5 <br />EHD 16 -24(2 -pg) 4,W13 FOOD PROGRAM OIR CONTINUATION <br />