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C4"' <br /> 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.sigoy.orq/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: ChI1907414 r11 Date: <br /> Address: U7/0 6n4� a City: Zip Code: <br /> Owner/Operator: C e- n v1/ Telephone: <br /> Program Element: Program Record: 6 Z Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 0 <br /> o e we 2vl n� 1 <br /> ce <br /> W 'V <br /> on YW <br /> a✓' SI re' _ <br /> ✓ , - <br /> n Mi L Y Ot C I f� <br /> 1t ; 0 — <br /> Item/Location ;, }e T. stat - „ ,_ Item/Location `. Te(t I Maki AA94) m stature <br /> ,/ -L C, i/- <br /> 6?C IAAL- <br /> Water Temperature warewashipg <br /> Name: ,M n, ,/,n Hand Sink: 'F1 �L, PPm Heat: �F <br /> Exp.Date: r r r'V112 11 ' � V arewashing Sink: 2 of rust.Amm.: PPm Other. of <br /> Received By/Tit] <br /> EH Specialist: ` If Phone: <br /> Time in: 1 ,11/0 Time Out: 1 I Pag j 0f'L <br /> EHD 16-24 (2n°pg) 4/3/13 FOOD PROGRAM OR CONTINUATION <br />