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SAN .JOAQUIN COUNTY <br /> y ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> �qz/Faara. Telephone:(209)468-3420 Fax.,(209)464-0138 Web:www.sigov.orD/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: :JnA ,C Date: <br /> Address: Ac A. City: Zip Code: <br /> Owner/Operator: Telephone: <br /> Program Element: Program Record: ' Inspection Type: I <br /> SB180 Posted Yes No� Permit Posted Yes o, Re-Inspection on or After:jaj <br /> RVATIO S AND C RRECTIV ACTIONS` w <br /> MATIAAAW b-1 . GLi , y i <br /> o m arc <br /> Au A 9-1nlr­ MAuxtatn <br /> (A�nfit Ln <br /> d <br /> v v oLt2iev WATo u Le. <br /> SSt s6 Ls <br /> o� <br /> ODMY, "01W Loffln PYWVIC-e <br /> 1 na- A <br /> t .e �' I/M A'n <br /> o W . <br /> Fdolffl Facility Hot Water Temperature Warewashing <br /> Name: Hand Sink: `F Chlorine: ppm Heat: IF <br /> Exp. Date: arewashing Sink: �F Ouat.Amm.: ppm they: <br /> Received By/Title: l� <br /> V� 7 <br /> EH Specialist: i7mAceR—q <br /> Phone: 21D <br /> Time in: i In Tlme Out: ✓V1 � Pagdl of <br /> EHD I6-24 i2i°pg) 4W3 I ' I FOOD PROGRAM OIR CONTINUATION <br />