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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: / <br />Date: t <br />aillir Or - _Ak fl <br />City: .,,.:rn f(:ri(3t j Zip Code: Address:" 2 k,/2 if4 /..-2c, .a.5 e • 1_-• ,:-- <br />9 ..4264.• <br />Owner/Operator: Telephone: <br />Program Element: Program Record: 0, 0 r Inspection Type: -) 4 I <br />SB180 Posted No Permit Posted -- No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />.AJ CI' V/ 0-01c,/k). I PEN 7 -1 Is7E0. <br />,Kny -7-0 /_s-50 E-- 0 7—Lf P-E--k.e.A/ 7- 0,"0 (---- e672414 77-- <br />p'V i -<-. PR ,42 • <br />el. A ic---t- II/1c A-J a L- / G Pt- 4 re. As I --r 1 s -rieicy. is*F-2•Eir <br />MI A- <br />PL.q y eio °L -P-- <br />Temperature Item / Location , _) <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />°F Name: 0 ie?,"? /TR.4,.._,L jEceff..ty Hand Sink: :f1-%--F, Chlorine: ppm Heat: <br />Exp. Date: (.77> <br />o/2 <br /> 4 Warewashing Sink: ,F Quat. Amm.: ppm Other: °F <br />Received By / Title: <br />‘C-ct P <br />EH Specialist: 40 Phone: <br />Time in: Time Out: Page ‘,of <br />EHD 16-24 (2 p9) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION <br />(1)