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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.oig/ehd <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: Date: ' _I — Z <br /> ddress: '2 <br /> t'a, , \ C� City: r-C�. Zip Code: <br /> Owner/Operator. \r\� ` �� Telephone: <br /> Program Element: Program Record: Z, 1 Inspection Type: - 1 <br /> B180 Posted ❑Yes ❑ Remit Posted ❑Yes ❑1 Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> 12 - <br /> e ipJc- S { t - <br /> ho\c1 C-^ t u = <br /> o. \e e 5 - c F <br /> \e <br /> e� <br /> C ee 2 tAOE <br /> d 4er L \S <br /> a 'n i e <br /> e <br /> V <br /> - <br /> w� in \,3v —42- 4o '3 _ <br /> (eS 2S1 \ C� ��\der c,-_-y rc, . ne 1- <br /> co <br /> 7 <br /> -- --- - <br /> Item:Location Temperature .,. Item/Location <br /> Temperature , <br /> re -4— c kgsF <br /> 41 <br /> Name. and Sink: ` - of hlorine: Ppm Heat: - �.� of <br /> Exp.Date: \ — k3^ arewashing Sink: eF uat.Amm.: PPM r <br /> ther: of <br /> Received By/Title: �/� <br /> EH Specialist,., ' _ p — _ _ ` _ hon 2�q _ 1 L , '`�` <br /> Time in: c \7C� Time Out: 1 C V Pag <br /> " f?J <br /> EHD 16-24(2n0 pg) 4/3113 J J FOOD PROGRAM OR CONTINUATION <br />