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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.siaov.ora/ehd <br /> GIFOQ <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: (W CTT 777 <br /> Date: <br /> Address: u(� �,mrytl � City: Zip Code: <br /> caner/Operator: �C �e Telephone: <br /> Program Element: Program Record: 4dE 9 9Z Inspection Type: <br /> S81 SO Posted Ye No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> �fb q h;� <br /> r . <br /> 11/f I <br /> S' /S M <br /> Al /n ��r <br /> 'Cti 4f /G <br /> s snyop K <br /> a at <br /> v t ✓tl� . <br /> bee A <br /> vi1aAbY <br /> Item/Location Temperature lidn/Location Tlemperature <br /> I I ✓I � C �F l� I - r - — <br /> Food Safety Certification Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: F Chlorine: ppm Heat: F <br /> Exp.Date: arewashin ink: `F Dual.Amm.: ppm Other: 'F <br /> I <br /> eceived By/Title: <br /> H Specialist: Phone: X10 1, ?D <br /> ime in: 1 Time Out: 1 � L( J Pageof <br /> EHD 16-24 (2n°pg) 4/3'113 FOOD PROGRAM OR CONTINUATION <br />