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l-t -yy /#£■ <br />Item / LocationTemperature <br />Food Safety Certification <br />Name:F <br />Other:Exp. Date:F <br />Phone: <br />Time Out: <br />EHD 16-24 (2rapg) 4/3/13 <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.sjqov.org/ehd <br />Name of Facility: <br />Address: <br />Program Record: <br />Permit Posted <br />°F <br />No <br />I I 11 I-- - <br />Temperature <br />, A CA. <br />A h - <br />fc-o? ) - 3 0 3 2 <br />' Page (of <br />FOOD PROGRAM 0IR CONTINUATION <br />Warewashing <br />ppm «Heat: <br />PPm <br />Yes No <br />Food Program Official Inspection Report <br />Date: <br />X . , Ay 7 ' City: Zip Code: <br />Sc.favJ—/x>4—_i------------------ - --—Telephone: <br />Inspection Type: <br />Re-Inspection on or After: <br />Za/-' - sr c <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br /><22 Ucr\a^ <br />___ <br />__________(Q S'' St jZ <br />1 t < Z£___---------- <br />/I L- f/b <br />---- --------------------------------------------- <br />•2-z/^Z /V.zX <br />■X-.z% <br />________ <br />______ )a^L Z <br />_____Zr~ CZ/sj' S ''I'-fZ-/' <br />(QPv ________ <br />_______________________________________ <br />ZO'O <br />—(,K^----------- <br />*0 2\vi____________ <br />___ <br />_ _____ <br />A a V\l\i_____ <br />C) xMq v % vfe <br />___________72' . rv ^ // / <br />___________WklsliM'________________ <br />_________"h "\if_____________ <br />(Q) <br />_____Iac^aA 6 ~ ____________ <br />f (eioX <br />______rUA/lZ A <br />5^^ f <br />4 - //7 ' <br />A"/ ima -a J 5 <br />--------------- <br />--------------_______________. ■ <br />Item/Location <br />_=__JL___jf=__ <br />Facility Hot Water Temperature || <br />land Sink: °p Chlorine: <br />z\ iiWarewashing Sink: oF jQuat. Amm.: <br />Received By / Title: . . A ’ zt <br />EHSpee^ist: L <br />Time in: g O