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OBSERVATIONS AND CORRECTIVE ACTIONS <br />HraiAcLz- ?) - ujaahjLn-A n . <br />LX <br />~bs4 <br />Item / Location Temperature <br />Food Safety Certification <br />Temperature <br />T 135 <br />Si <br />Name: <br />Exp. Date: <br />Chlorine: <br />Quat. Amm.: <br />Warewashing <br />Heat: <br />Other: <br />ppm <br />PPm <br />°F <br />°F <br />EH Specialist: <br />Time in:Pag Vf 3 <br />FOOD PROGRAM OIR CONTINUATION <br /><2^ <br />(fy) Q-CjiL7 C conf-) <br />____— H^r~)cA <br />___YW-V__-HiKi___pW <br />cOtTV-Lt <br />tz3 <7S in <br />4t 7 <br />i'G <br />Name of Facility: <br />Address: <br />Owner/Operator: <br />Program Element: <br />SB180 Posted Yes No <br />Received By / Title: \ <br />EHD 16-24 (2Mpg) 4/3/13 <br />Qru. <br />b(4f?73> / s <br />Program Record: | <br />Permit Posted Yes <br />64t)d<-WiO <br />_ AJ CjlrT^Cr' <br />Facility Hot Water Temperature <br />Hand Sink: op <br />.^^---'''Warewashing Sink: op <br />San Joaquin Col 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.org/ehd <br />Ip si <br />A-1 mm <br />Food Program Official Inspection Report_______ <br />+c<s4i I Date: <br />City: zipCode: <br />_______iPhone: 0,3-7-^119 <br />Inspection Type: <br />Re-Inspection on or After: <br />^-Wv-HQn c^> not S-€ft <br />c&- ( .9 r-Rn praiM’dad <br />y < wip I rotnclu va R r <br />- LAA-n^? I <br />__niisx- > <br />< o cn cL^- <br />— 4o y -e VL <br />Item/Location <br />Op- 6)<gtlAs shaLj <br />u ) cH-ki cd r m______ <br />L> u end -V Csjjtec~f' <br />Phone: ^^ 3^7 <br />Time Out: I I ’ (-fa)