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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.siqov.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility<7 -..\ C...:(2./ " - \ CA,...r----ic-t2)\---1Z.. Date: if \I \CV\J (-01 - \ q 23 <br />Address: .kci\ 'So c Aft,_ City: C„..1-.....:\ Zip Code: 9.• zc,--7... <br /> \A Telephone: <br />. <br />Owner/Operator: .--S-'' <br />Program ElemTtA z j ‘ \oc..5 Program Record: k t4 ,0c,t •-i lo / s 0S9 Inspection Type: I 1 <br />SB180 Posted Yes / No Permit Posted Yes No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />. - <br />C\3.U2,1r\ ‘4?) ' 5 Qe-4--7-)0S? 7 9-0-2_ c‘-- - <br />-.-:- -, c_cp. c -1------.0 <br />r--- <br />T <br />c*N-Lx-A-1-,, ( u --.0-<2. "*Nclizei) c•-fif 4 <br />r I Th t_ '5 VT ,k1\ C\ k(.- Aou,-Q. .c._ -J <br />iz (\) cpro A.A) (4-z_ i 1,--o •se,4-1--1-z_Q). 1 • <br />.\ , 0 ,:\-...9-jc-z - N. c__C, \ <br />• <br /> <br />-C'je-a2'%•-•1/4. _ 1 .-452--CA. ' )0( 4 e> <br />\‘ <br />-1 V`---2-20 <br />i <br />k;\.PJ Ck 2_ F 1--- <br />'0--Ic --A2\ r•--e c."-z_ k --1\-0-01) C--LscNi-,-,k---V-k. — er'c,N-:. ' rN (1,07-) 0,--1 4---AZ----SIN <br />\ <br />‘__,) V-=1 -g>i.--A,Q0,..... V---\\(--1 -.-. Z-- <br />Nr -- ccis r <br />00 P\sk W <br />Cc-) . C. \--0 ..'_' <br />x-....?..32)\-, • -X (N.Q27,24 ci-ria * <br />_J <br />Item/Location Temperature Item / Location Temperature <br />(A-Q-XS \ -- -V-r• r•-•,- Ce% Lk\ \ ,5 <br />f5 ) S cc---Ac ---m OF <br />Food Safety Certificationir— Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: oF Chlorine: ppm Heat: °F <br />Exp. Date: Warewashing Sink: . Quat. Amm.: ppm Other: 'F <br />c-tet,k Received By / Title: ---c-00,1, <br />-Phone: 2_0 9 _ (.0 \ (0 _ s (..) 2 „s EH Specialist:e \>2‘ (._.' <br />Time in: ---7 ,55c:;k Time Out: q3 \_1,-s-c- Pagel of <br />END 16-24 (2,4 pg) 4/3/13 FOOD PROGRAM OIR CONTINUATION/„.