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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 East HazeIton Avenue, Stockton, CA 95205-6232 Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.sigov.orgiehd FOOD PROGRAM OFFICIAL INSPECTION REPORT Name of Facility: Date: 0 1 -- 6 — 2%5 Address: /9 5, P 5 fi W )" i 6 City: L /A i costV Zip Code: 9 s 23 tc Owner/Operator: Telephone: Program Element: / tr 6 6 Program Record: CO 0,e• 55 ii 7 5 Inspection Type: 6oki• etA INT SB180 Posted jfles No Permit Posted Yes No Re-Inspection on or After: OBSERVATIONS AND CORRECTIVE ACTIONS c-e) IN"7 "1101- t N q ----1 Cotr Le) M • A e--KA v e!y. 0 t4 z' 1 -re ANC' A4 -r ii-if '7' 14-4g, OA 0 Sii-5 4=71Z:)0 P. igi cl I try ovoNse_. vj b 15 6 U C.0-M--e-L#A-i-P1-1-1-r i-Prj2 0 9e12-A OP-- Z) -P- ,S.,/:7 ry%17:74,017 iILL -1—y. I-I A 5 1.4 CI' 0/ -E efli 1-1-- " N p i s 0 19 1-0 V A -T-E- ,c,t4 PSCZ-An )--r /2-•se3, u (1)1 1\P 5 U c- K— A .5 r--- 1101a- A i4 Nufli-- PE-P,AA r-r AND AN to u'i ) 12---)D 1-11A -r- i 0 Peig--A-7ea...0 .F----. 1,2E . S -77 2 4 , 491v1 FRG! L I -t-X A1 -17 - -rk—E a_ A Li t4- g411 On ici" A CO-A ccr•i 7- to T4-1E- .17 /Via 9) L,e z::,‘w r--K ci L.- rT)4/ , A L.5 a \I SR I TI FX7 -r - -r of te-Pripg- kk AS A S 61_1,WS Pea_n4 i-i- Wt-ri-k- -C.- Commus,i rt)e 17 vEt-gerYieTV AF OtIc ---1" & P\R_PNA 4s TA (Ngsz.t tzt- 2-€ 4 i-A-UN/1012 FA-00 2- i 32.2 i7 iz.,6 5 L1-1 7 2-fi Item/Location Temperature Item! Location .1 j- 1 Temperature Food Safety Certification Facility Hot Water Temperature Warewashing Name: Hand Sink: .F Chlorine:ppm Heat: °F Exp. Date: Warewashing Sink: oF Quat. Amm.: ppm Other: °F Received By / Title: EH Specialist: CA..., Au D 1 N— AMA, 12-r) Phone: /4) 511., 1%j ..... CO ?2,. 3 Time in: 2. : , p M Time Out: • 1 3 e m Page of EHD 16-24 (2^d pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION