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Zip Code:City: <br />Inspection Type:Program Element: <br />Permit PostedSB180 Posted <br />re <br />1$ < <br />Id ^512, <br />Item / Location TemperatureTemperatureItem/Location <br />Food Safety Certification <br />Chlorine:°FName:ppm <br />Other:Quat. Amm.:Warewashing Sink:°FExp. Date:°F ppm <br />r. <br />Time Out:Time in: <br />EHD 16-24 (2"apg) 4/3/13 <br />* . r : <br />Name of Facility: <br />Address: <br />Warewashing <br />Heat: <br />Received By / Title: <br />EH Specialist: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />:________:______'_____i .________ <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 />n i w tm <br />Li <br />Facility Hot Water Temperature <br />Hand Sink: op <br />A <br />5 <br />Z________ <br />Payf4 <br />FOOD PROGRAM 0IR CONTINUATION <br />z . I <br />Pho,”! y- 4/Z- <br />PH_______ <br />Food Program Official Inspection Report <br />ci,t: <br />Z4 C;<U y 2 4, In.p.ConTyp.: <br />Yes No Permit Posted Yes No Re-Inspection on or After: / <br />cu'VY'e^.f ■»SLO 2^ <br />(9 it (jx,.t'4U WM.55 <br />P/Z VSU 2 2 ______ <br />No Re-Inspection on or After: