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■OO-Vv-Q /~1 <br />\\Y^\qo(~ \<^ \p^~> <-12K » • <br />' <br />hlorine:Name: <br />iuat. Amm.:'arewashing Sink:Exp. Date: <br />3 Phone: <br />Xy-X <br />FOOD PROGRAM OIR CONTINUATION <br />- r-eo^ <br />4VjO ft V-^ —Vo \ QO~ I <br />Item / Location <br />L <br />San Joaquin County <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.org/ehd <br />Other: <br />Temperature <br />u°ir <br />"F <br />Ac -y, K /X <br />°F <br />______ <br />/M H <br />°F <br />■\Ux?-5 FqqcA__________ <br />p vxv>p SV-jlg, <br />OsrV>Jxr> “S <br />2.0^- <o I b- 30 2^- <br />TimeOut: Page of <br />- ___________________________OBSERVATIONS AND CORRECTIVE ACTIONS <br />"'f , ■ t :__S 2____ <br />Received By / Title: <br />EH Specialist:V~< <br />Time in: q* <br />EHD 16-24 (2™ pg) 4/3/13 <br />\Qj)Sr\U •" <br />CXJ<v^n ^V71 V <br />/ (vAwg <A<?xV <br />_____________ <br />C \ -VsA -€\t <br />Axx \XcV~V\ V <br />Warewashing <br />ppm HHeat= <br />PPm <br />So GL <br />( qjcV Vo <br />Food Safel <br />Temperature ________Ite....' L_ <br />(VO) VK^X / lerr- <br />2A \ F7 _ <br />Facility Hot Water Temperature <br />iHand Sink: °p <br />cV\ TOO -VrV CS) I <br />Item/Location <br />K kO <br />_____________Food Program Official Inspection Report <br />Name of Facility: (\ \ ? ; x \r -x -\ GF^A /~ Dat6: ' R • Z^f <br />Address: J \ AAqxJo SF _________City: AA H_______________ZiP C°de: <br />Owner/Operator: Telephone: <br />Program Element:^ 7 y | Program Record: Q y 2_ S '~t Z Q ~7-S Inspection Type: > <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: