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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.siciov.orq/ehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: d,-... AL <br />Address: 7 <br />/i WI"? 0 ' ' Ci---- 41 itU 0 1f3 7 4111 <br />Date: ieg i <br />1°. 4 City: Zip Code: ac.. <br />A 51DC-treiNi C r— <br />Owner/Operator:cSf 01 / 10 <br />Telephone: <br />Program Element: Program Record: # jig, <br />775 0 <br />Inspection Type: ifThdift_c_ <br />SB180 Poste Yes No Permit Posted Yes No Re-Inspection on or After: <br />, <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />/11111K.,/, iiii..0_ 1.1 i g. 1 0 I i . I ..- a -ALL . _i <br />W <br />2 <br />U 4O <br />1 <br />i -eV L.S7)616" <br />i ri/I-P4d-- a+ .1 <br />g m . rtxx e kOGL ha.rtd-,01 C-/-eAZO- ii-16±- <br />p OW I Ob /7,Wh (Vcd / <br />66,717 fi cf-az 0-) ‘u-t_d d , ... / <br />/AIAIA') a\ ko.eaa, 56nd • jak-Ke4jeavore <br />cociW ) oidee a4 (-$ <br />en -- <br />allp2eit-1 <br />6irot trAlt/AIL a-1A 1-6dAy, ve--n eq q <br />f <br />j i) Keep NI rtaitevS G/ 4S-rd m f 110-fr? /20-1- / <br />OKlu I & C UP 8\01 2L 911v2 pee-----rce- <br />• loae.,,& <br />/ <br />ill LLA iK-' f .',e'PWilliefiiii dAti.,,,0 A... /1 <br /> <br />Item/Location Temperature Item / Location Temperature <br />1 door conzrn cool LI-IP <br />i Inn pt-' •••/,' ot,co liF <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: <br />/7' LIfl <br />Hand Sink: <br />/ 0/ <br />o F Chlorine: ppm Heat: • <br />Exp. Date. Warewashing Sink: o F Quat. Amm.:PPm Other: . <br />Received By / Title: , <br />Mil 0 4•A ‘-a—flaKIAIIL , <br />EH Specialist: ..., Phone: <br />l — <br />Time in: Time Out: Paget of i <br />EHD 16-24 (2nd pg) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION