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are <br />ar Q2V.k <br />Mop <br />Food Safety Certification- <br />- Mwst -^> 42 f <br />Item / Location <br />Name: <br />Exp. Date: <br />Chlorine: <br />Quat. Amm.: <br />■n rowashing <br />PPm <br />ppm <br />! Heat: <br />, Other: <br />°F <br />°F <br />-fcd^K/< <br />■ Temperature <br />lof3 <br />FOOD PROGRAM OIR CONTINUATION <br />Received By/Title: <br />EH Specialist: <br />Time in: || - <br />EHD 16-24 (2"«pg) 4/3/13 <br />Facility Hot Water Temperature <br />Hand Sink: »p <br />Warewashing Sink: Op <br />Name of Facility: <br />Address: <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes <br />San Joaquin Cou y <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 />•> c ocYaipcrkt cte <br />poH <a <br />kfaTPH rvexV- Vp <br />tww c cg-t Ghk nod i oa . <br />OTA & wp <br />Qvibney vg\e Wyina . <br />•- Tc' ■.NC’-4-cr fc^r s Vt <br />Phone: <br />Time Out: , . qQ Page <br />~ Ts Hocved. <br />- food vs cfr w - <br />ave ay W- <br />Fa yD Oom a <br />ware wokHinq k ______ <br />-iW ace wnews <br />\fopvCv\eny yesr (cmt-ro'l <br />- ho/ of vs, <br />S~ford oV foisds. awou <br />- u)fd -yfofok av€ azA€d <br />- n'() khn^S. ptzN\de TZxVfoT <br />2r 2r... dr IV-or > <br />i/U-jHss ”” ‘■ve’rs/l.ocTticri- < : i . ,.:;■ Temperature <br />c c/rrec-^ an ki4€ <br />and cfofo cVsM> <br />V'\S>cup-Hnua pmcrc-o roc\6Ki. <br />yp-Q pr-ap knh gx) ot\Kj <br />qv TKC 3 cmp knH, '____ <br />Vr\JL wfofof. PomonC- and <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />eS qU TVX food vandgr^ ^resanX <br />3 Cc/v^p <br />? Sdn. <br />o nfo <br />Food Program Official Inspection Report <br />£an FastTval Date: q/io/ih <br />ftMpcrr City: awfW zipCode:d^ok <br />auodafoye i>a Telephone: <br />foCfo Program Record: 40^^___________________Inspection Type:-yeMp .jg^vOtT V <br />No Permit Posted Yes No Re-Inspection on or After: