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aP.soc SAN JOAQUIN COUNTY <br />? ENVIRONMENTAL HEALTH DEPARTMENT <br />N: X <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone. (209) 468-3420 Fax. (209) 464-0138 Web. www.sioov.org/ehd <br />�IFORN` <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Date: I �Z <br />Name of Facility:-JyqO o _l -g 3s <br />// / <br />Address: 55 _ Lh /) City: S�'Ock4ok, Zip Code: .-- <br />Owner/Operator: L Telephone: <br />Program Element: / Program Record: O Inspection Type:, <br />B180 Posted Ye No Permit Posted Yes No Re -Inspection on or After:112 S 2 <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />- "300 �D <br />ku P r /,l tiro , IC4,& at 0-1 t Co,a./ s; n <br />Olt S <br />6PLok"73 <br />�'uyel <br />i e 2F <br />or o <br />J , , %� C44r PL�r <br />M. c <br />W L `'EGA 4>'ei2 /ice M. <br />/ <br />d ✓� rkold -t'wkk_ /-I telyt, C'* 7 � ` Lt-4✓�tlr <br />e sp� : V f <br />10 -nA44 <br />v� ✓o 'sS e /S 6^ <br />Teeimperature <br />Item / Location Temperature <br />//Item/Location <br />SO 6>- <br />1 <br />/ <br />f -e Lc.' I F <br />-c-I5� S` io- OF <br />aooJd <br />PfName: <br />efe Certification Facllity Hot WOale`Temperature <br />Warewashing <br />\ '-S ��` Hand Sink: 1 0 c) of Chlorine: ppm Heat: I-FExp. <br />Date: 1 i7 a�arewashing Sink: DO 'F uaL Amm.:2"O ppm ther: <br />o' oC.� <br />Received By/ Title: ;-5 & / � P <br />EH Specialist: - Phone: .6 1 3 D 3 S <br />me In: [0:00 A M Time Out: 12- : Q c) M Page 01 51 <br />EiD 16-24 R-pg)4313 <br />