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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: j kvurAitus p rDAucei <-11.._q 53 sP 7613 Date: dt5 0\3 <br />ddress: 167 mz,Axt 4.lie City:517,-dio,„ Zip Code: <br />Owner/Operator:/ Ja-ra.rni /10 ,f- 6/•Al -- <br />Program Element: / (da Program Record: p ?ocis Inspection Type:10007 ita <br />SB180 Posted Yes (No Permit Posted Yes Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />Oa , 4. Ildi / . . , to 4_ in ......-_ <br />Ot., I' 1 I L , d7)74-e -Old 6 mazr ec <br />-09a-e 4e-- 4,011 slate pin.t.rid, <br />Who Le ra- popAa(a_gt artig__ 1 <br />0 Po(s-/--- p&entfi--. P.e,e_ma--stv (et? <br />ot< Iv ISSUI2 gNOA, V poind-- v41,e& peefiLt"--- <br />_rc,e t,:‹ pa_,L8( <br />Item/Location Temperature Item / Location Temperature <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: 0F Chlorine:PPm Heat: . <br />Exp. Date: <br />i <br />Ware ashing Sink: 0 Quat. Amm.: ppm Other: . <br />Received By / Title: leopp. <br />rPhon <br />, <br />EH Specialist: e: -41 61-SD g <br />ime in: Time Out: Paget of/ <br />EHD 16-24 (2", pg) 4/3/13 <br /> FOOD PR RA