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IP <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.sigov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: jAj <br />AfLb i=VEL <br />Date: u�-ori <br />Address: <br />City: <br />Zip Code: <br />Owner/Operator: <br />Telephone: <br />Program Element: <br />8180 Posted Yes <br />Program Record: <br />No Permit Posted Yes No <br />Inspection Type: <br />Re -Inspection on or After: <br />a&VRVATIONS <br />an <br />AND CORRECTIVE ACTIONS <br />a <br />r /t/ <br />Y <br />/ <br />A <br />rVe tit/ <br />SGC% <br />4r on i <br />coIlia S' <br />o , <br />e <br />e �h <br />r <br />i <br />�7 y <br />v <br />Food Safe Certifica Facility Hot. Water Temperature <br />Safety <br />Name: ! , Hand Sink: v! <br />f_ <br />/ <br />'em / Locations - <br />Warewashing„ <br />of Chlorine: ppm Heat: of <br />-r <br />Exp. Date: <br />arewashing Sink: <br />of uat. Amm.: ppm <br />Other: of <br />Received By/ Title: <br />EH Specialist: CL <br />/ - Mu <br />4,0/� <br />Phone: <br />Time in: ? • <br />Z <br />Pa of <br />Time Out:/ 3 ^ 155, <br />EHD 16-24 (2b pg) 4013 FOOD PROGRAM OR CONTINUATION <br />