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City: <br />-L-U ^SiizaJX <br />(X l Cci h tg .nz>4-uCa-K1^ <br />Pro rt-C'sZ 4~ <br />PHP <br />{Ai -C-k Kn -ex-4 <br />/Tskwr 1(S^C) u r ov •/ <br />C'i 1 V < <br />Item/Location Temperature <br />Food Safety Certification <br />Chlorine:Heat:Name:°F <br />Exp. Date:°F <br />Phone: <br />Warewashing <br />ppm <br />Hv-'P <br />Item/Location <br />Q-K <br />temperature <br />o 4 -kt 4- <br />San Joaquin Cour <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 />-V____ <br />nt <br />-p.s f <br />Pro (jt <br />- LolcK <br />lOD <br /><£> Sophie's <br />- LLcc OC <br />Locj <br />prr 064313^ <br />Yes No <br />Page . of^ <br />FOOD PROGRAM 0IR CONTINUATION <br />Oorr^_____ <br />P)r i i~/ I <Cp\~b o n <br />jCLa^ Lwof.Iv.tTy <br />^2? pui m rr^-t S <br />- UJa4-€r~ -Vbr <br />to <br />p nl KZ-f n-V <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes <br />b '~j <br />ppm other: <br />dUr-f^ <br />S-hops <br />Facility Hot Water Temperature <br />[Hand Sink: ojp <br />Warewashing Sink: [Quat. Amm.: <br />UL- Zx /H <br />d-Cyz-g r t? c\ . < L( <br />— CLo n +tS rv-m moc-HO >1 ■ <br />Time Out: , 7C. <br />Received By/Title: <br />EH Specialist: t-— <br />Time in: | ' <br />EHD 16-24 (2ndpg) 4/3/13 <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />n d <-?s h_x <br />P C IAJ<3 rnn 3 <br />d jm s, c <br />______________Food Program Official Inspection Report______ <br />Name of Facility: lYkirm ^.4- bwt2 <br />Address: L-Zc-3 A4<xr,ndr.zt City: zipCode: <br />iMklWl________________________________________________Telephone: 6oq^^02 <br />Program Record: ___________________Inspection Type <br />No Permit Posted Yes No Re-Inspection on or After: <br />■'4