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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.siqov.orgiehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: Ira_ 'k n,x-k--- Date: V )2\ <br />Address: <br />a <br />IQ , son City: AtcanNi Zip Code: <br />-S— <br />Owner/Operator:, <br />,R,..N <br />Ca\ N \I 0 <br />Telephone: <br />Program Element: Program Record: p p_Dss, ---,, I gs Inspection Type: <br />SB180 Posted es No Permit Posted ry-a., No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />Qw-keck Namms , ptv_42a_a_ to,()Le. <br />V.0101 YU_ ,n99Pch M, nu mAyY Vt 6-Egd-t ern s <br />no (.e-tn ci9 ecAioy). <br />Item/Location Temperature item / Location Temperature <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: .F Chlorine: ppm Heat: <br />Other: <br />. <br />Exp. Date: Warewashing Sink: °F Quat. Amm.: ppm . <br />Received By / Titlex l‘\ N \ LA 0\ tl' ) U ......1\. <br />EH Specialist: .ik..A Avik Phone: <br />Time in: cz- , ctryi Time Out: 5Ef11 (A rn Page of <br />EHD 16-24 (2^d pg) 4/3/13 FOOD <br />R.R053g1g5