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City: <br />© <br />(£z*x <br />I TemperatureItem / Location, TemperatureItem/Location <br />Food Safety Certification <br />A <br />XM ^70 I T I <br />NoNo <br />°F <br />°F <br />Name: <br />Exp. Date: <br />Received By / Title: <br />EH Specialist: <br />Time in: <br />hlorine: <br />luat. Amm.: <br />Page ^of <br />FOOD PROGRAM OIR CONTINUATION <br />< r-i <br />__— <br />/V/V’/____ <br />. tt. \ - ry ' <br />— <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 />Food Program Official Inspection Report <br />ci,y: ,z'p"de: <br />u u — Telephone: <br />Inspection Type: <br />Re-Inspection on or After: <br />UiU^ <br />w: rkIIl||'« LOW. <br />Program Record: <br />Permit Posted Yes <br />iOj> <br />“iipo <br />Phone: ( <br />Timeout: <br />I'M <br />y ttys <br />S A4/ <br />/< kP <br />Ml u . , <br />V ^£7 ; ~ <br />__3 ( __ <br />____Kfsl (VT A t Vi <br />z^Z <br />A T <br />_______________ <br />31 ----------- <br />KU ho’ __________ <br />C.ciwm/Ca| ^^c-V <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />&&& ____- <br />2 if co <br />________Ll^ — <br />kfrlJ 4/^//pO ___ <br />— I x L ■*>(<-. <br />xy :......y____ <br />c/z —- __ <br />____________ <br />..r.Z^r7<__________ <br />F ^4u,P____________ <br />_A>4y----------------- <br />------------------------------------ <br />/a / ^Z/Z£>z^ /vL <br />Name of Facility: L C 3 v <br />Address: L| y <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes <br />Facility Hot Water Temperature <br />land Sink: ep <br />iZarewashing Sink: op <br />EHD 16-24 (2* pg) 4/3/13 <br />Warewashing <br />ppm H“': <br />ppm other: