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o¢¢�l"• SAN JOAQUIN COUNTY <br />b ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.s'oov.org/ehd <br />4UFJ'A`' <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facilityc�^fes - <br />\ C--\ <br />Date: <br />ddress: 2 2_ v SQ City: <br />T�- Zip Code: <br />\ <br />a <br />wner/Operator: <br />Telephone: <br />k- Zeus- 4'i <br />Program Elemen • \ <br />Program Record: SN C OSI <br />Inspection Type: <br />B180 Posted Yes No <br />Permit Posted Yes No <br />Re -Inspection on or After: <br />7r- <br />e <br />2 : e <br />2 <br />tel` <br />0/ -be <br />fe <br />\ ne <br />s <br />k a, <br />O <br />We�- <br />OWO!cks 19N.,Q <br />9 <br />- r��nf �49 F <br />/ S' f <br />12 <br />L_ <br />'t--� <br />s- k <br />t2 <br />e e <br />142 <br />V"kV- <br />4 O <br />.00dSafsty CertMeati6W <br />Name: <br />C e X13 <br />Facility Not Water Tem erature. <br />Hand Sink: 12-0 'F jChIorine: Ppm Heat: 'F <br />Exp. Date: <br />arewashln Ink:' �� <br />uat. Am ppm her: `F <br />Received By / Title: In„^n <br />W� uL q <br />775 <br />EH Specialist: <br />- <br />Phone: ZCR - kc)O2� <br />Time In: 3S <br />Time Out: i. ZS rn <br />Page of <br />EHD 16-24(2- Pg) 413113 1 FOOD PROGRAM OIR CONTINUATION <br />YM <br />