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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.org/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: pa ,, , , , , • 1.-..--gutt avcir _tat", ..„,_ F--ez41- s kiv 5 bviv e: c i nj...3 <br />Address: Aga <br />01% 4( f av citys-_,,vaLit,,k j Zip Code: 4C Or <br />Owner/Operator: ------ <br />1 I <br />Telephone:LS— <br />Program Element: es5 Program Record: p 2o5 - Lilo 53:3 <br />Inspection Type: <br />SB180 Posted 400No Permit Posted Yes No Re-Inspection on or After: <br />_ <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />0 <br />50 V- <br />ated,e,111/$ 12J/ °bSe9110, a4e- 4-t- F1 19?"'611 -- 4- <br />rtkif ( C inain-Wtn,e4 Gcl 4/ F ev g 01A) &Or z_o ttAiw. <br />4- Wilem rsidam-t-zed )O 12k is r_ejoiar_odi 1--..epla_c_Q <br />Nall o rnoit, a__, lz.e.dot-e, a-croitief. <br />011 -7) tcsue A peyirki-- io-nce_ peynwF lc-i6. is 19czil. <br />Item/Location Temperature Item / Location Temperature <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: e F Chlorine:Heat: ppm °F <br />Other: °F Exp. Date: Warewashing Sink: .F Quat. Amm.: ppm <br />Received By / Title: 0 <br />0 <br />EH Specialist: 'AA 6 6cterL- <br />Phone: 3_0 _(.0 11),_ 70 V‘o, <br />Time in: Time Out: PageZof z <br />EHD 16-24 (2rd pg) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION