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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.s'aov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: Date: <br />Address; <br />City: Zip Code: OCA <br />Owner/Operator: P2,^ 1 J Telephone: <br />Program Element: <br />Pr gram Record: <br />35'6Z 1 Inspection Type: <br />B180 Posted Ye No Permit Posted es ' No Re -Inspection on or After: <br />OBSERVATIONS AND CORRECT ACTIONS <br />o <br />d <br />�I= <br />..- .. <br />Item/Location nture <br />-- ..., , _ a -' <br />C8 Tempeure <br />,00d Safety Cartificati. ' Facility Hot Water Temperature I" Warewashing <br />Name: Hand Sink: "F Chlorine: ppm FHeat: "F <br />Exp. Date: arewashing Sink: of <br />Dust. Amm.: ppm her: of <br />Afu <br />Received By/ Title: V _ _ Av <br />EH Specialist: Phone: _ <br />_ 2 <br />_/ <br />ime in: Time Out: <br />ag <br />EHD 16-24 (2ntl p9) 4/3113 FOOD PROGRAM 018 CONTINUATION <br />