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SAN JOAQUIN COUNTY <br /> �+ ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> . d.. .�; Telephone:(209) 468-3420 Fax: (209) 464-0138 Web:www.sagov.org/ehd <br /> ��FdR <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: 1 f'G, C C r Date: <br /> Address: c- City: 7 Zip Code: <br /> Owner/Operator: 1_J G,� Telephone: <br /> Program Element: , y�2 1 rogram Record: S ZQ� , 1 5 ©y O Inspection Type: <br /> SB180 Posted Yes No Permit Posted Yes No v Re-Inspection on or After: <br /> O3SIERVATIONS AND CORRECTIVE Ad <br /> 3ca ,n <br /> 1o5 E <br /> 3 <br /> Temperat emperature <br /> 2Z) <br /> _ Facility Hot water T - •Warewashing <br /> Name: Hand Sink: aF Chlorine: ppm Heat: 7 J'FExp.Date: arewashing Sink: ofQuat.Amm.: ppm ther: <br /> Received By/Title: <br /> EH Specialist: w h Phone: <br /> Time In: Time Out: ` Page of <br /> EHD 16-24 (2n0 pg) 4W 3 FOOD PROGRAM OIR CONTINUATION <br />