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City: <br />ex <br />TemperatureItem / LocationItem/Location <br />Food Safety Certification <br />it <br />Name: <br />&qxDate: <br />Chlorine: <br />Quat. Amm.: <br />San Joaquin Cc jty <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.orq/ehd <br />Program Record: <br />Permit Posted <br />°F <br />°F <br />Food Program Official Inspection Report <br />______D^: |O/|4/[-<b <br />Zip Code: Q <br />Telephone:^ <br />Inspection Typeq^^ y> ^60 V <br />Re-Inspection on or After: <br />I Temperature ]| <br />=• <br />Facility Hot Water Temperature <br />Hand Sink: op <br />Warewashing Sink: op <br />-Nd <br />wnyUc, hot on Xue . i <br />xor xnos, o <br />Warewashing <br />" ppm ]|Heat: <br />ppm Pther: <br />Ld-y- <br />A <br />• • • j <br />'N L. . . ■■ . <br />AW yv g <br />until ' , -friPcK rxg obwiicx . ___ <br />jy vZnAcr WtC u£eJ W AM Wwv <br />Received By / Title <br />EH Specialist: 7~ <br />Time in: j <br />EHD 16-24 (2nd pg) 4/3/13 <br />Phone: Q <br />Time Out: Pagd^of <br />'*OT^ FOOD PROGRAM 0IR CONTINUATION <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />Ut_____________ ________________.___/tnd cW Somiplfe vatb Mtilto cWS- <br />wth SMnoN r% .Mr_____ <br />Name of Facility: <br />Address: <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes <br />VAmaU yert <br />Program Record: QU U <br />No Permit Posted Yes No <br />Oz(zpA64 <br />(~gTlQ ViWS _ _____________________T____ <br />- -The Wro ^ornjXjgc, g\g hot on w w -KMp. Qy <br />xiivdor cvaM> tw \gr oy€n ca-V P-VM. ite <br />•To Qp-ipie vam, <br />-NQ wArrn wow w SVaW. foiling,_______ <br />WZ'Vs - yruv dzWo/, <br />CX M <br />until j^o^g <br />? p.gg<> <br />VW &Unxyl£<>, ___