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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 East HazeIton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orgiehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: -r ts.t4 1:7 A GI u AreiNA ix. ur 6.6,,A E.L Q Li e ..A L- l- 7... Date: 01_ t --7 .. 2.3 <br />Address: I 0 6 9 N1 \NI 1 Lis 0 ki W Ay City: gto ,..r.oki- Zip Code: <br /> <br />lephToypnee:0 Owner/Operator: f> 4 L 0 <br />A u T1 5/- 39O -yg-A :2.2._ <br />D 1k 01\0 51 InspectionTe Program Element: I 60 Prc)gram Record:L 7(0741 Program .,....).,62 - - -2:,:52, co wt., LA 1 NT <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />tonA e IA imr- twies-rt cusrvi.efa .. <br />5,1-c, R.& oug..tep vS ''T-111-.)q Ude -17•Aeis- Al 411 I 12-6 ac- citsfri e i....A I, kfr ; <br />A an cyan. w..., t N-i -r-t-- 1:2. 001-S L. -A-+4r 9--r-0.12-E. il=12_10, --t-1A arovcv +4 <br />53 b pky A '•-t-r:47„ 1-3 <br />.rlz.v iiVr lCli-1 : S 4=6 Se_e- -1--c, S-tr,P- c;..N.3 t.15-,a RtS R,tm i 1-3 <br />cl. woo L- Al- KJ -r Lel- Ixti 0 Ei 00 Lii_ A PeR AA i-r- 1$ t-r eED <br />A 1,1.ID 1-=. LS C.1.3,S—SE,C) 1- Y •Pag D"tR.,iv1_1175:_,"_NUD_C-l- _1-. (1-1 e-S . <br />ow 4.1 e 12_ 0 i y PE; M 1 1-rE-c)VC: 42- 192E fil) .Cle„,"cteli:)___ .'.1) <br />SA I.ES OK\ 4, p I 1:::. N. 0-r e.-)ez ae--.V -E- R. TA B Les 0 <br />Poo t› 17:, KE-P/ Goic. k-- I IQ n U-r- g L.ID 6 - <br />7 L-c-As5--- fro-M . S t G Nytli-U1 Oi (1)-Eg_se g.c-cG viN <br />11-4 LS R-GRD 42--r u,) iss Ni 01- rAq el-Li e_ 4.. i Li ne.4.)-12._ -VD <br />IA4 A I i,i 1-i4i 1,1 SzpciAL i ti ci, b.1.5.-r-pqiNI-G <br />Item/Location Temperature Item / Location Temperature <br />1 <br />I <br />1 <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: oF Chlorine:PPm Heat: , <br />Exp. Date: Warewashing Sink: °F Quat. Amm.: ppm Other: °F <br />Received By / Title: <br /> <br />EH SP ecialist• <br />C— 1--7"-L) Phone: 2)013._ sic I __ g <br /> <br />. <br />2...z <br />Time in: Time Out: Page; of t <br />EHD 16-24 (2'd pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION