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> <br />t <br />Zip Code: <br />r Telephone: <br />Program Element:eI <br />■ <br />/- / 7'A- <br />J /-ci <br />ISuJee.ff n » ) S .7 <br />I K <br />£/u J e <br />I A <br />X 41 <'- yo r- <br />c les? yb <br />Item / Location Item / Location Temperature Temperature <br />Chlorine °FName:PPm <br />Other:Quat. Amm.:Warewashing Sink:°FExp. Date:°F PPm <br />Received By / Title: <br />Phone:EH Specialist: <br />Time Out:Time in:I ■' w <br />j . <X ,c <br />/Jo I <br />Warewashing <br />Heat: <br />X ~ d&c. r <br />i y <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 />ZD__ <br />o iia< <br />-IX J <br />Name of Facility: <br />Address: <br />11.st)_____________________ <br />EHD 16-24 (2nd pg) 4/9/12 <br />Temperature <br />V I F' <br />5) -10 PL <br />\Z ) <2 I <br />0 > 5 pl <br />()^ > <br />be -IcU ? <br />uJ A e r\ <br />1- t~t 1 r <br />& bt' \/e <br />Food Program Official Inspection Report <br />/m fAz/n DatM/21-'2 <br />City; I... t l . ZjpCode: 75 j> j <br />o c /<f <br />er' c J <br />b M,' <br />C&t YfC <br />cf <br />zKyi <br />/ c>5 op___ <br />Ia.s e. <br />Facility Hot Water Temperature <br />Hand Sink: op <br />■i -I; <br />I <br />Food Safety Certification <br />Page^ of, <br />FOOD PROGRAM OIR CONTINUATION <br />Ill <br />3 aK <br />Mu <br />J Mr_____ME <br />SB180 Posted Yes No <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />_____________________ __ ■ .. _________ __________________________________________________________ <br />/ ; n - >.?6 / j 9 F Pl) <br />(J c s_______ci I_______g r <br />Item/Location <br />Tro Her <br />Tr; <br />h c 4- <br />G f l'''' <br />___LiU__ <br />t______ <br />Owner/Operator: <br />Kff <br />C C c \a t. <br />Inspection Type: <br />Re-Inspection on or After: <br />5______O A <br />7/? <a r\ F h v y <br />D C 1/ "Q5S l___________ <br />Program Record: t’ , j q : <br />Permit Posted Yes No <br />2V)c.a <br />T7 J______ <br />hou hi <br />1 d-