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4^ <br />( <br />a <br />Temperature <br /> <br /> <br /> <br />Food Safety Certification <br />Chlorine: <br /> sQuat. Amm.: <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 />LrjiBQ <br />iC n <br />°F <br />°F <br />Clty: (StDCkffihJ <br />No <br />Facility Hot Water Temperature <br />Hand Sink: »p <br />Warewashing Sink: op <br />Name of Facility: <br />Address:-^^,'^ <br />Owner/Operator: V <br />Program Element:’i "C <br />SB180 Posted Yes No <br /> Pagj^of <br />FOOD PROGRAM 0IR CONTINUATION <br />-to <br />vca <br />Name: <br />Exp. Date: <br />Received By / Title: <br />EH Specialist: 1 it <br />ri,ne'n: in a <br />EHD 16-24 (2"°pg) 4/3/13 <br />Warewashing <br />ppm l|Hea^ <br />ppm |Other: <br />hV <br />UA <br />HnmcK Mi <br />___g. <br />Program Record: <br />Permit Posted Yes <br />phone: <br />Time Ou.: i <br /> <br /> CA-^IOOP PPn ferilcA4 <br /> OtUCC , „ -II <br /> ^fe-ihrP <br /> frffi w^^Vad <br />Food Program Official Inspection Report_______mw <br />______^pho^to-^^-ZS 5 <br />Inspection Type: fHf?. 6' \ V f} ~ <br />Re-lnspection on or After: * <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> (|) igofSASuy- <br />ig) vA <br />ffe-ns^ < <br />I rtonr LAps-ffie <br />/ y