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a44�i"• SAN JOAQUIN COUNTY <br /> z•�a Eos <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> Bd..•. .•,.•a Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.ora/ehd <br /> CIFdr�� <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: s <br /> ddress: / G City: Zip Code: <br /> Owner/Operator: IAIdlknLa`- Telephone: 'LOq U <br /> Program Element: //J Program Record: OS Inspection Type: hP <br /> B180 Posted Yes lY No i Permit Posted Yes No Re-Inspection on or After: /-I/ <br /> 2' <br /> OBSERVATIONS CTIVE A TIONS <br /> f rC I J t- u! os - <br /> 4#"_k23_ Q <br /> ✓ Ci n " <br /> a ✓ ri' a V, !1 c <br /> ISw 6tc <br /> hr' I 1A AJC — S rI ktk a GVllfl-I n j L I GW' I ✓ UI?rlri A - <br /> F)IUD GtG k f i - <br /> t✓ tyttjm Se ✓ <br /> Ihahve C k w a I k-a md - Ift <br /> e (.1%1 1 <br /> .Temperature- <br /> n2q 00 `ud/ . a W wa/lam Ar'UI+N 9 <br /> a lr Lf - ac a i eJ l/ � e --� 3 9F <br /> i�A JA '7 / tf al u re <br /> cility Hot Water Temperature _ warewashing <br /> Name: upqm 44 Hand Sink: 'F Chlorine: ppm Heat: "F <br /> Exp.Date: Pd3 ir <br /> arewashing Sink: of r <br /> uat.Amm.: ppm ther: of <br /> [EH <br /> eceived By/Title: . r��� �/7"]�� UA <br /> Specialist:_ t �/ Phone: I <br /> me in: 9.I A Time Out: jj' O <br /> Pig f <br /> EHD 16-24 (2nO pg) 4/31113 FOOD PROGRAM 018 CONTINUATION <br />