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aPquly.S 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.sogov.org/ehd <br />�IFOP� <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: <br />-f-Z �t% y <br />�.JJ <br />U Date: Dtr. <br />ddress: /24/ S ublNse.9fdi <br />8 1JC— city: <br />zip Code: <br />05 <br />caner/Operator. M olitao 0��,� <br />Telephone: <br />Program Element: Program Record: Com. Z ` <br />Inspection Type:a� <br />8180 Posted Y 0 Rerfnit Posted 0 1 <br />Re -Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />, . <br />D NIOZA 0 <br />/� <br />. <br />" Item/Location <br />Food.Safety Certification <br />Name-: i . <br />Temperature <br />Facility Hot Water Temperature <br />;Hand Sink: <br />item I Location, .'-= - _ • - _'- tore <br />F Warewashing'''' <br />of Chlorine: ppm Heat: of <br />Exp. Date: I <br />ir arewashing Sink: <br />of ruat. Amm.: ppm er: eF <br />calved <br />ived By I Titl <br />X4 C <br />8 <br />EH Specialist: LA L9. .,t�� �Q 4 e�. <br />Phone: <br />6 <br />Ime In: - <br />oil "q� <br />Time Out: D; 41 S' Pag e`off <br />EHD 16-24 (2 -pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />