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HO 6--6133 <br />City: <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />£lK <br />Item/Location <br />Name:Chlorine:°Fppm <br />Exp. Date:Warewashing Sink:Quat. Amm.:Other:’F ppm <br />Phone: <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 />Asap <br />__Pv# Lr-i Aj2._ _ <br />v-kv / r\<X^L< S~T <br />fix L a r~ <br />o <br />a <br />oh |Qf t <br />Received By/Title: <br />EH Specialist: <br />Time in:PageNet <br />FOOD PROGRAM OIR CONTINUATION <br />Temperature <br />S <br />Warewashing <br />Heat: <br />\O OQ <br />EHD 16-24 (2"dpg) 4/3/13 <br />fop s <br />nruw________ <br />rru2^4- <br />Food Safety Certification <br />Item / Location <br />ip iO S i) 6? r <br />_ L cL/nr- <br />M7 Q fvi <br />Facility Hot Water Temperature <br />Hand Sink: op <br />°F <br />^■'Cc <br />a) pc6k- <br />___rJ?ro>in <£i i^) s <br />(3)^bl6„aZ <br />I57T <br />5 __HaasH_________ <br />___- _Ls u (4-y_c 4 <br />— j~yrO Vax SM-hmc rru-hr ruo-f- <br />- r Qxilf f <br />______tz L\J \°F Q r__/_ a vj-c _______ <br />Time Out: || ' C| O <br />_____________Food Program Official Inspection Report______ <br />N.me of F.cility: p,-; ^3^., |°M»! <br />O«n.,<Ope,«M, ^Ifk+OA TfrcU ____________________________T.l.ph<,n,; <br />Program Element: Program Record: ______________________Inspection Typeiy-^ <br />SB180 Posted Yes No Permit Posted Yes No Re-Inspection on or After: <br />S-ektAl Ge 'R-t pz>CA r' <br />o i_) cm La. H O <br />4i*F ._ j^p <br />^Temperature7s^ <br />llo~)\ <br />\^b°f <br />I ^ir <br />'STzj t:k ~hun ~Pi * d <br />Program Record: <br />No Permit Posted Yes