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SAN JOAQUIN COUt <br /> A1O cGG <br /> y� ENVIRONMENTAL HEALTH DEPARTMENT <br /> O1. :< <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • .. . ip• Telephone:(209) 468-3420 Fax:(209) 464-0138 Web:www.sogov.org/ehd <br /> Qc;FaRa <br /> FOOD PROGRAM OFFICIAL INSPECTION REPORT <br /> Name of Facility: � z4_4 e F-,--S JL�Va ` Date: d .- <br /> Address: 'a oR el-en-Ie t— City: �� � Zip Code: c�S <br /> Owner/Operator: 154f /) 1� Telephone: <br /> 7-r of <br /> Program Element: Program Record: 5 O Inspection Type:'�rn <br /> S6180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> F 0, /74 <br /> _�L_a� 4- T? " <br /> r at,(- r - <br /> -U-k"31'/ wits h " 4 �S�eaF cJ - c�4.�f- op rt o c.A-) - A)-e-e <br /> lc,az h - ►' h sf- - S Co*%_4'44 <br /> O r . Ci2 CIO t <br /> Rp n 8 <br /> .l <br /> 4 Ito a- Gs � <br /> kA,low ature item 1 Location Temperature <br /> tl F00cl Warme-Y q 61- <br /> m L ro �- <br /> I <br /> Food Safety Certification Facility Hot water Temperature Warewashing <br /> Name: Hand Sink: of Chlorine: ppm Heat: of <br /> Exp.Date: Warewashing Sink: of Quat.Amm.: ppm Other: of <br /> Received By/Title: <br /> EH Specialis . Phone: 11153—12 <br /> Time in: 1 * V Time Out: 1 *0C Pag of <br /> EHD 16-24 (2" pg) 4/3113 FOOD PROGRAM OIR CONTINUATION <br />