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,4®•s,� SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />r.., Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />y Dz Q C LC <br />2 Date: <br />.� <br />Address: <br />City: <br />Zip Code: <br />Owner/Operator: <br />Telephone: <br />Program Element: <br />Program Record: <br />Inspection Type: <br />SB180 Posted Yes <br />No Permit Posted Yes No <br />Re -Inspection on or After: <br />ai <br />o ��D�ATicYti�, <br />/ <br />>t <br />AAG bA <br />% . <br />, tH 6 w&,,& poob FA c j I 7Y <br />PF <br />i! tjA 15 hV — <br />0094LEC-t', POS lT 57fA Nb Zc P C0'0& <br />/ <br />—"#4C44- ro"-' rW9C <br />S/ 75V&7 MFF, <br />o eP ern e-.Aec-r <br />2D - 5 -Cl - e'9 9 0 <br />kF 03 57 !NSP 0 R <br />19- AS 7` oyS! <br />D T <br />CVRkV7Mr z P6_ <br />AT N M <br />S! I -P gf o Ivo <br />TO /SS 6 OZ p <br />Is <br />eAWA <br />G/C <br />� <br />149 <br />V/4 "rW <br />q /gy.`perature - <br />I ' n 0Wp OOF <br />'l ocatioo' - <br />is i - <br />Name: Nee 6.b <br />'`t <br />Facility Hot Water Temperature <br />Hand Sink: Ih� <br />Warewashing <br />of hlorine: Ips ppm�Hea�t:Exp. <br />Date: <br />arawashing SIU 12f <br />Ouat. Amm.: Ppm <br />Received By / Title: <br />EH Specialist: <br />Phone: <br />Time In: o 8 <br />Time Out: Pag of <br />EHD 1624 (200 pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />