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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: P2.- ,P gF7:-.17: Al r / Ci.P1 '1-'7).- Date: J/ /57 2_3 <br />Address: a ..:.-5 4 f 2. gi.... tl,:_-,y2. p cz,City: <:).-f- Code: ty<eintUZip <br />Owner/Operator: Telephone: <br />; Program Element: 6 /7 Program Record,:e..._.e .ft ,7N f 16/ / ,,,,<<- . or ..c..._, Inspection Type:re... ty—r7N-F <br />SB180 Poste< Y• • No Permit Posted( Yes , No Re-Inspection on or After: <br />111.111=11.111.111 OBSERVATIONS AND CORRECTIVE ACTIONS <br />III <br />X TWE - . I , 1 - - - - "lip, R. Vicfro 01/ Ai Co 0 t_€92., AN .p 7 -12- r 'p I? i Re- , <br />e a o t Fie_ cti EP-_<(-- I 4 #7"7-1- 7 0 V elm-- q C0,9 / F, A Vbi),.57— <br />4-0 /14 fq ) /N-, —7- osQ / 04,) Li fr: 1, )e— BEto et.) - 1'-0 k7 /4"? Ye. <br />Item/Location Temperature Item / Location Temperature <br />e‘k---019 ip— mob./-Pdr-s- Y 9 r <br />6 e 1/-40 he- REeieli-0 W ei 2_-. <br />iv z),02.47) <br />px /4- 1 P 11 I R--5 `5'- i 'eV' <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: I, /2) pl p..... p u e j.,:i.,#- Hand Sink: / D O, .F Chlorine: ppm Heat: . <br />Exp. Date: 97// 4 /f > 2,y Warewashing Sink: (// of i Quat. Amm.: ppm Other: . <br />Received By / Title: <br />r !CEA kj" Ct.° l I tA. <br />EH Specialist: Phone: <br />Time in: Time Out: Page \of <br />EHD 16-24 (2nd pg) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION