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Name <br />Zip Code:Clty: <br />SB180 Posted <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />IS <br />X <br />fX. <br />so <br />C \ - <br />Item / Location <br />a1^- <br />hlorine:Name:°Fppm <br />•ther:luat. Amm.:Exp. Date:°F°F ppm <br />Phone: <br />EHD 16-24 (2nd pg) 4/3/13 <br />Temperature <br />San Joaquin County <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 />J<i <br />Warewashing <br />ll-ieat: <br />IS <br />Safety Certification <br />Temperature <br />UM F <br />- ■ <br />| F <br />Facility Hot Water Temperature <br />Hand Sink: op <br />warewashing Sink: <br />2^0^ - b \ b- <br />Time Out: <br />(' 0?) r\ \ <br />Received By/Title: FSc/yyA <br />EH <br />Time in:Page_of <br />FOOD PROGRAM 0IR CONTINUATION <br />gB' <br />ptirsxto <br />(hi <br />Program Element: / ( ipH ^(ro9ram Recorcl: <br />Yes No Permit Posted <br />Item/Location <br />-H ) Covv->b>r'0________ <br />________ <br />Inspection Type:^^;^/ -p <br />Re-Inspection on or After: <br />s pQgcIzj1 \ O <br />----------------------------------r-------------- <br />>It \ QO pp on C \ - <br />__________Food Program Official Inspection Report <br />oFFaciiityT^Date: -- <4 ~ 2. <br />Address: SVoc ZipCode: M ? <br />Owner/Operator: Telephone: