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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.stgov.orcilehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: K C JS ejLtyka <br />WO 0 <br /> t\l --At )(c l'- J <br />Date: ' d094 <br />Address: L/L/691. Kftfisas /3.1/er„, City: ray ? ri---i) Zip Code: e.P F2- ' 5 <br />Owner/Operator: .-7—/-77/-7 g.- 77 a r) Telephone:c-7, / pe,,&...e. <br />Program Element: Prog ram Record: fik 03-2, 7 93-- Inspection Type: <br />/Lb <br />SB180 Posted No Permit Posted es No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />9U 10 VAS1-1/Yrie) OQUA- Si(bcp 50 -Wiak a. IS \II <br />11(17X/tk-- <br />9-0 2.4 vevi'mul-• ofiCu 1)emtAJ-- <br />k s ALA' .c2)e- V <br />Item/Location Temperature Item / Location Temperature <br />00D—R -we, - scArY\ --svILU (L-(O pAli)3\mc,ce.o_ <br />YY1W1- 3--AM t5tr <br /> <br />Food Safety Certification Facility Hot WaterT mperature Warewashing <br />Name:T9J3 f‘ Hand Sink: 1 6 .F Chlorine: ppm Heat: . <br />Exp. Date: 4 <br />Warewashing Sink: t 1.._..) . Duet. Amm.: ppm Other: 0 <br />Received By / Title: C7 <br />EH Specialist: <br />- B ,kte/e -- <br />Phone: 9.D kl...--, (0 a 6 _ .5)() 4(9 <br />Time in: Time Out: Pages of I <br />EHD 16-24 (2" pg) 4/3/13