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City: ' <br />No <br />g)-O <br />J <br /> Jr <br />^J~ZzZsktr, P. <br /> <br />Food Safety Certification <br />hlorine:Name:ppm <br />Other:luat. Amm.:arewashing Sink:Exp. Date:ppm <br />Phone: <br />>Z- <br />EHD 16-24 (2"° pg) 4/3/13 <br />I— <br />rss^ <br />nun <br />Name of Facility: <br />Address: ( <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 />i <br />Program Record: <br />Permit Posted <br />Received By / Title: <br />EH Specialist: <br />Time in: <br />Warewashing <br />Heat: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />7 5^ <br />FOOD PROGRAM 0IR CONTINUATION <br />°F°F <br />°F <br />Yes No <br />f7?) t j rtd -J. <br />--------- 3 64^1? <br />_____Inside. <br />9 ' <br />Facility Hot Water Temperature <br />land Sink: op <br />z? 4^* <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes <br />~ lo^ <br />Time Out: . , Page. of <br />Il (irf ' - <br /> <r^, i<X ■ iZ/JiA'rll <br />Food Program Official Inspection Report______ <br />L Street Date:Clly: Zlpc°de: /?S-3ZZ— <br />' Telephone: <br />Inspection Type: <br />Re-Inspection on or After: 7 <br />I Location I Temperature <br />______________--------------------------------------------------------------------------------------------------------s-------------——-------------------------------------------------------------------- <br />Mf ^K)0 pT. rtnsw <br /> lx 'j-rt dp £(') ad <br />c<| 3 Sy cl* ypr-rx'^./ (0 f—!-------- <br />(^) Ccrtbx.A (j^cJ IoZM " ________ <br />H S f Ul f <br />e 7^> K7 c —v <br />pep ci^vx—pr>f ^z/ ( V—J ‘ 7 r < Z^—z <br />Item/Location [Temperature Iter <br />fi/7t/7z/f 'I 'plrJoAL <br />jC4,^ A. <br />• 1/'l^cf*