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|oQ Q ( <br />otO r <br />ice <br />x> <br />i <br />yyeg-X^ <br />Temperature <br />-^S<s^ <br />ure f <br />Phone: <br />Time Out: <br />Chlorine: <br />Quat. Amm.: <br />°F <br />°F <br />San Joaquin Coun\ <br />Environmental Health Department <br />1868 East Haze?on Avenue, Stockton, CA 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 464-0138 Web: www.siqov.org/ehd <br />Heat: <br />Other: <br />____ <br />ut4-K <br />H/WF IH <br />0*0 yju^ <br />Pagejof *7 <br />FOOD PROGRAM OIR CONTINUATION <br />Item/Location <br />EHD 16-24 (2nd pg) 4/3/13 <br />pu3 <br />tw__ <br />Warewasl <br />ppm <br />ppm <br />Address: <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes <br />(gUA4.-4^s4-gH~>|p5 <br />(J .. <br />Food Safety Certification <br />Name: <br />Exp. Date: <br />Temperature <br />IQZfe <br />1£S~F <br />Ibg F <br />Name of Facility: <br />No <br />r r> <br />•tKAuM~n^o Certd -C<41 c <br />Received By / Title: <br />EH Specialist: <br />Time in: <br />»QF <br />/ ^1^*, /A4Lc<tX~»w-»A f~ <br />■'A'.______ <br />__^1 F «r~ <br />..............................................■. <br />7^ <br />^er_______ <br />Facility Hot Water Temperature <br />Hand Sink: op <br />Warewashing Sink: op <br /> — <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />j _____________ <br />-fticclS <br />L><f~~vk> \C<^ i a < <br />Food Program Official Inspection Report <br />P^r-fc, Date: <br />ZipCode: <br />f /"> Telephone:- f-f— __________________________________ <br />Program Record: Inspection Type: ^^7 — <br />Permit Posted Yes No Re-Inspection on or After: