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4"'"• SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />c4 iFd'A'p Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.s'aov.ora/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: 6)D6 i- <br />�; nDate: <br />7 777= <br />ddress: 1'1 <br />V <br />City: La <br />Zip Code: <br />Owner/Operator: <br />C <br />Telephon <br />^^� <br />Program Element: / Progifam <br />Record: 26 D <br />Inspection Typ n <br />SB180 Posted Yes No Permit Posted Yes No Re -Inspection on or After: <br />RAFFIVATKIMA AND C _ V .ACTIONS <br />t�NLr <br />r\A <br />7.) <br />lZ F atm <br />td <br />1e <br />c <br />✓ <br />n <br />l✓LC1 <br />P1 M <br />�(lo cttaktAvLef <br />W It <br />to el e- <br />+� <br />vmt Cd <br />ItenJLoeatio <br />.. {ie <br />.; <br />are: <br />u <br />Food Safety CertificationlHand <br />Nae: <br />Facility Hot Water Temperature . <br />Sink: of <br />hlorine: <br />_ Warewashing <br />ppm Heat: of <br />Exp. Date: <br />arewashing Sink: of <br />oust. Amm.: <br />PPM <br />Other: eF <br />e: 777 <br />E <br />Phone: <br />_DI — h <br />luY7�1 U <br />Time Out: <br />Pag ' of <br />EHD 16-24 (2^^ pg) 4/313 FOOD PROGRAM OIR CONTINUATION <br />