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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: '62- LcSA7 PP-C. b it• <br />Date: <br />Address: <br />1/15:50 <br />City: 1.\) La ) t......50/ff 1.A) A y TA 0 (44.0,4 Zip Code: <br />Owner/Operator: Telephone: <br />Program Element: A(5 y Program Record: i •Kos 5 3 y/20 Inspection Type:frzo <br />SB180 Posted (r'i No Permit Postexl 41107 No Re-Inspection on or After: <br />111111._ OBSERVATIONS AND CORRECTIVE ACTIONS <br />Mo Cr(' it- k / 0 )A. ;7 - 7 04 3 . <br />5 PAc P 15) r17, r 16 pls <br />Item/Location Temperature Item / Location <br />Food Safety Certification Facility Hot Water Temperature Warewas <br />Heat. 0 Name: Hand Sink: .F Chlorine:PPm <br />Exp. Date: :War • n .F <br />ewashinV <br />Quat. Amm.: PPm Other: I <br />0 <br />Received By / Title: I <br />P.-7 <br />EH Specialist: _ Phone: 4.7,,, .5,6- / _. serp.2g <br />Time in: Time Out: Page/of/ <br />END 16-24 (2nd pg) 4/3/13 <br /> FOOD PROGRAM OIR