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0.44 'N.F 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.sigov.org/ehd <br /> CiFoa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> ame of Facility: Z Date: k-"4 -2-3 <br /> ddress: ) C � + _ ^ City:T r Zip Code: <br /> ner/Operator: \_ �, ,�^ = � c \ Telephone: <br /> Program Element:\ \ `Program Record: ^C 2 2 C� l.,l Inspection Type: <br /> B180 Posted D Yes D Rermit Posted J Dyes DIV Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS L <br /> 5 � CZA <br /> 3 - 50 <br /> tik [= 4 0 I lf25K <br /> 1A <br /> o, e <br /> r�L 120 <br /> e� <br /> rj 1 <br /> e C <br /> d\G c Cb ��7 5 4 - <br /> mgerature Item/hgcation _ Temperature_ <br /> 2 — <br /> b\o. �'c c h' \ter 5 = (rn - n 14 <br /> Food Safety Certification Facility Hot. <br /> Name:'—'Hand Sink: \ O eF hlonne: ppm Heat: F <br /> 1.J <br /> Exp.Date: p — �O_ 2 arewashing Sink: of uat.Amm.: t t ppm ther: /' ,F <br /> Received ey/Tittle: � C . c e-m ` <br /> HSpecialist: Phone: OZZuf <br /> ime in: ,cam Time Out: <br /> EHD 1624 <br /> (2-pg) 413113 FOOD PROGRAM OR CONTINUATION <br />