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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.orcilehd <br />FOOD PROGRAM OFFICIAL INSPECTION REPORT <br />Name of Facility: ry‘ 0 1 0 e, Date: <br />Zip Code: VoI <br />Telephone: <br />Address: City: 5tiotry,K) to wit& c; , <br />Owner/Operator: (Aal,-) 00..0A.rikAjpo NtryLeAtub <br />Program Element: / / .9__ / 6 Program Recbfd: f 53 ke\SL,./ Inspection Type:Rovj <br />SB180 Posted Ye No Permit Posted Yes No Re-Inspection on or After: <br />- <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />+ VITA clx_ mkr-/-- tc, e_eArt-E- pelAnt, <br />(SY) S Patx-i-v\_12.„ Ci9etilM• n tr 410;;'-,'01 V i Offth <br />\() rf,e- -I 11, S-$19-e CA brn 0 <br />Item/Location Temperature Item / Location Temperature <br />I <br />Food Safety Certification Facility Hot Water Temperature Warewashing <br />Name: Hand Sink: .F Chlorine:PPm Heat: °F <br />Exp. Date: Warewashing Sink: . Quat. Amm.: PPm Other: °F <br />Received By / Title: X UP 01 0 1,,A <br />EH Specialist: <br />w(tsx <br />CA (* Alain__ Phone: a00.1 _ Ida 310 <br />Time in: c-'2{)A, ill Time Out: S-r 2,,,c6- Pagel ofl <br />EHD 16-24 (2nd pg) 4/3/13 <br /> FOOD PROGRAM OIR CONTINUATION <br />7Ros-szirl-