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Food Program Official Inspection Report <br />Date: <br />City:Zip Code: <br />Owner/Operator:Telephone: <br />Program Element:Program Record:Inspection Type: <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />I <br />- <br />I <br />I <br />I <br />Item I LocationTemperature Temperature;Item/Location <br />Food Safety Certification <br />Chlorine:Name:°Fppm <br />Other:Warewashing Sink:Quat. Amm.:Exp. Date:°F°F PPm <br />Received By I Title: <br />EH Specialist:Phone: <br />Page ofTime Out:Time in: <br />FOOD PROGRAM OIR CONTINUATIONEHD 16-24 (2"°pg) 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.siqov.org/ehd <br />Name of Facility: <br />Address: <br />'2 * <br />_________ <br />Warewashing <br />Heat: <br />Facility Hot Water Temperature <br />Hand Sink: op <br />H (i t <br />______