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Pc\G \ <br />NoYesSB180 Posted <br />OBSERVATIONS AND CORRECTIVE ACTIONS <br />C 7 7 <br />I <br />TemperatureItem / LocationItem/Location <br />ill r <br />Food Safety Certification <br />Name:°Fppm <br />Other:'arewashing Sink:Exp. Date:°F°F ppm <br />Received By/Title: <br />Phone: <br />EHD 16-24 (2nd pg) 4/3/13 <br />• ’ <br />S • -S . L <br />EH Speciali^^^^^^^ <br />Time in: <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.orq/ehd <br />Warewashing <br />Heat: <br />2^0 I <q <br />Time Out: <br />Food Program Official Inspection Report______ <br />Date: - 2, <br />A S <br />Name of Facility: \ <br />Address: T) C 1 <br />Owner/Operator: <br />Page ^of <br />FOOD PROGRAM OIR CONTINUATION <br />Chlorine: <br />Quat. Amm.: <br />Temperature <br />____ <br />Facility Hot Water Temperature <br />[Hand Sink: <br />__________I CTO ppgA C __ <br />(J5Qjp \^r\- <br />oOr S <br />> iC)Sr <br />TgVgJ gAcj? A VltO <br />) \o6 r <br />Program Element: 11.02 / ■ . PrMrarn Record: <br />Yes No ' Permit Posted <br />c La <br />City: SWCAgh ZipCode <br />Telephone <br />SO^ lnspectionType:y2x^uJk-\rQ I t]^ <br />Re-Inspection on or After: <br />VjcVL <br />Vk>V <br />^4